Ultrasound as a diagnostic and management tool in hidradenitis suppurativa patients: a multicentre study
Por:
Martorell, A, Roldan, FA, Rull, EV, Ruiz-Villaverde, R, De Gabriel, JR, Martinez, FG, Sarro, DV, Pastor, MV, Blanco, CC, Palacios, JMS, Bandera, AIR, Ramirez, JCP, Sanchez, CS, De.Gorosabel, NM, Wortsman, X
Publicada:
1 nov 2019
Resumen:
Background It has been reported that clinical evaluation consistently underestimates the severity of hidradenitis suppurativa (HS). Objective To determine the usefulness of ultrasound as a diagnostic tool in HS compared with clinical examination and to assess the subsequent modification of disease management. Methods Cross-sectional multicentre study. Severity classification and therapeutic approach according to clinical vs. ultrasound examination were compared. Results Of 143 HS patients were included. Clinical examination scored 38, 70 and 35 patients as Hurley stage I, II and III, respectively; with ultrasound examination, 21, 80 and 42 patients were staged with Hurley stage I, II and III disease, respectively (P < 0.01). In patients with stage I classification as determined by clinical examination, 44.7% changed to a more severe stage. Clinical examination indicated that 44.1%, 54.5% and 1.4% of patients would maintain, increase or decrease treatment, respectively. For ultrasound examination, these percentages were 31.5%, 67.1% and 1.4% (P < 0.01). Concordance between clinical and ultrasound intra-rater examination was 22.8% (P < 0.01); intra-rater and inter-rater (radiologist) ultrasound agreement was 94.9% and 81.7%, respectively (P < 0.01). Limitations The inability to detect lesions that measure <= 0.1 mm or with only epidermal location. Conclusion Ultrasound can modify the clinical staging and therapeutic management in HS by detecting subclinical disease.
Filiaciones:
Martorell, A:
Hosp Manises, Dept Dermatol, Valencia, Spain
Roldan, FA:
Hosp Puerta de Hierro, Dept Dermatol, Madrid, Spain
Rull, EV:
Univ Autonoma Barcelona, Hosp Santa Creu & St Pau, Dept Dermatol, Barcelona, Spain
Ruiz-Villaverde, R:
Hosp Virgen de las Nieves, Dept Dermatol, Granada, Spain
De Gabriel, JR:
Hosp Parc Tauli, Dept Dermatol, Sabadell, Spain
Martinez, FG:
Hosp Sureste, Dept Dermatol, Madrid, Spain
Sarro, DV:
Hosp St Joan Despi Moises Broggi, Dept Dermatol, Barcelona, Spain
Pastor, MV:
Hosp Arnau Vilanova, Dept Dermatol, Valencia, Spain
Blanco, CC:
Hosp Gen Univ Gregorio Maranon, Dept Dermatol, Madrid, Spain
Palacios, JMS:
Hosp Costa del Sol, Dept Dermatol, Marbella, Spain
Bandera, AIR:
Hosp Univ La Paz, Dept Dermatol, Madrid, Spain
Ramirez, JCP:
Hosp Gen Univ Alicante, Dept Dermatol, Alicante, Spain
Sanchez, CS:
AbbVie Spain SLU, Madrid, Spain
De.Gorosabel, NM:
AbbVie Spain SLU, Madrid, Spain
Wortsman, X:
Univ Chile, Dept Dermatol, Inst Diagnost Imaging & Res Skin & Soft Tissues, Santiago, Chile
Pontificia Univ Catolica Chile, Santiago, Chile
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