Martorell Antonio, Giovanardi Giulia, Gomez-Palencia Pilar, Sanz-Motilva Virginia
Department of Dermatology, Hospital de Manises, Valencia, Spain.
Università Cattolica del Sacro Cuore- Policlinico Universitario A. Gemelli, Rome, Italy.
Dermatol Surg. 2019 Oct;45(10):1237-1244. doi: 10.1097/DSS.0000000000001916.
Recent studies suggest that there are different fistular subtypes in hidradenitis suppurativa (HS) patients who are associated with variable therapeutic outcomes.
To describe clinical and ultrasound features that characterize the different fistular patterns in HS and to evaluate the response to medical therapies.
A retrospective study developed by a well-recognized center specialized in HS analyzing both clinical and ultrasound (US) aspects of fistular structures in HS patients was performed. Medical therapy response was evaluated through follow-up visits at Week 24.
A total of 117 fistulas detected in the skin of 40 patients were evaluated. Four different types of fistulas were described: dermal fistula (Type A), dermoepidermal fistula (Type B), complex fistula (Type C), and subcutaneous fistula (Type D). Fistulas Type A and B showed a complete resolution after 6 months of different medical therapies in up to 95% and 65% of cases, respectively. Contrary to this, fistulas Type C and D showed no significant response after a medical intervention.
The US evaluation seems to play an important role to define these important structures that will help the clinician in elaborating a personalized combined medical and surgical management of the HS patient.
最近的研究表明，化脓性汗腺炎（HS）患者存在不同的瘘管亚型，这些亚型与不同的治疗结果相关。
描述HS中不同瘘管模式的临床和超声特征，并评估药物治疗的反应。
由一个知名的HS专科中心开展了一项回顾性研究，分析HS患者瘘管结构的临床和超声（US）方面。通过第24周的随访评估药物治疗反应。
共评估了40例患者皮肤中检测到的117条瘘管。描述了四种不同类型的瘘管：真皮瘘（A型）、真皮表皮瘘（B型）、复杂瘘（C型）和皮下瘘（D型）。在接受不同药物治疗6个月后，A型和B型瘘管分别在高达95%和65%的病例中完全消退。与此相反，C型和D型瘘管在药物干预后无明显反应。
超声评估似乎在定义这些重要结构方面发挥着重要作用，这将有助于临床医生制定HS患者个性化的药物和手术联合治疗方案。
