Wortsman Ximena, Castro Ariel, Morales Claudia, Franco Carmen, Figueroa Andres
Departments of Imaging and Dermatology, Institute for Diagnostic Imaging and Research of the Skin and Soft Tissues, Clinica Servet, Faculty of Medicine, University of Chile, Santiago, Chile.
Office for Clinical Research Support, Santiago, Chile.
J Ultrasound Med. 2017 Dec;36(12):2403-2418. doi: 10.1002/jum.14282. Epub 2017 Jun 26.
To compare the sonographic characteristics of pilonidal cysts and hidradenitis suppurativa.
A retrospective study of sonographic examinations was performed on 2 groups: 1 with pilonidal cysts and the other with hidradenitis suppurativa. The sonographic characteristics of the pilonidal cyst and hidradenitis suppurativa groups were analyzed, compared, and correlated, including an analysis of the histologic findings. For the pilonidal cyst group, the distribution, morphologic characteristics, location, shape, diameter, axis, vascularity, and scarring were also described. Statistical analyses included Spearman, Wilcoxon, Kruskall-Wallis, χ , and Fisher tests.
The sonographic examinations of 84 patients were reviewed: 43 with pilonidal cysts and 41 with hidradenitis suppurativa. The comparison of the morphologic characteristics of the key lesions between the pilonidal cyst and hidradenitis suppurativa groups showed no statistically significant differences (P < .05). Both groups had similar dermal and hypodermal saclike and bandlike structures that communicated with the widened base of the hair follicles. Retained fragments of hair tracts within the lesions were sonographically detected in both pilonidal cysts (100%) and hidradenitis suppurativa (83%) and also found on histologic specimens; however, the density of hair tracts per structure was higher in pilonidal cysts. Sonographic signs of scarring were absent in 63% of pilonidal cysts. Only 2% of pilonidal cysts showed communicating bandlike structures.
Key lesions of pilonidal cysts and hidradenitis suppurativa have similar sonographic morphologic characteristics, which suggests that a pilonidal cyst may be a variant or localized form of hidradenitis suppurativa. The retained fragments of hair tracts frequently detected in both entities may be caused by ectopic production of hair and not by embedding. Common therapeutic strategies and research can be designed for both entities.
比较藏毛囊肿和化脓性汗腺炎的超声特征。
对两组患者进行超声检查的回顾性研究：一组为藏毛囊肿患者，另一组为化脓性汗腺炎患者。分析、比较并关联藏毛囊肿组和化脓性汗腺炎组的超声特征，包括组织学检查结果分析。对于藏毛囊肿组，还描述了其分布、形态特征、位置、形状、直径、轴、血管分布及瘢痕形成情况。统计分析包括Spearman检验、Wilcoxon检验、Kruskall-Wallis检验、χ²检验和Fisher检验。
回顾了84例患者的超声检查结果：43例为藏毛囊肿患者，41例为化脓性汗腺炎患者。藏毛囊肿组和化脓性汗腺炎组关键病变的形态特征比较，差异无统计学意义（P < 0.05）。两组均有类似的真皮和皮下囊状及带状结构，与增宽的毛囊基部相通。在藏毛囊肿（100%）和化脓性汗腺炎（83%）中均通过超声检测到病变内残留的毛发束片段，并且在组织学标本中也发现了这些毛发束片段；然而，藏毛囊肿中每个结构的毛发束密度更高。63%的藏毛囊肿无超声瘢痕征象。仅2%的藏毛囊肿显示有连通的带状结构。
藏毛囊肿和化脓性汗腺炎的关键病变具有相似的超声形态特征，这表明藏毛囊肿可能是化脓性汗腺炎的一种变异型或局限性形式。在这两种疾病中均频繁检测到的残留毛发束片段可能是由毛发异位产生而非嵌入所致。可为这两种疾病设计共同的治疗策略和研究方案。
