Department of Dermatology, Hospital de Manises, Valencia, Spain.
Department of Dermatology, Hospital Puerta de Hierro, Madrid, Spain.
J Eur Acad Dermatol Venereol. 2019 Nov;33(11):2137-2142. doi: 10.1111/jdv.15710. Epub 2019 Jun 23.
It has been reported that clinical evaluation consistently underestimates the severity of hidradenitis suppurativa (HS).
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.
Cross-sectional multicentre study. Severity classification and therapeutic approach according to clinical vs. ultrasound examination were compared.
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).
The inability to detect lesions that measure ≤0.1 mm or with only epidermal location.
Ultrasound can modify the clinical staging and therapeutic management in HS by detecting subclinical disease.
据报道，临床评估始终低估了化脓性汗腺炎 (HS) 的严重程度。
确定超声作为 HS 诊断工具的有用性与临床检查相比，并评估随后对疾病管理的修改。
横断面多中心研究。根据临床与超声检查对严重程度分类和治疗方法进行比较。
共纳入 143 例 HS 患者。临床检查分别将 38、70 和 35 例患者评为 Hurley 分期 I、II 和 III 期；超声检查分别将 21、80 和 42 例患者评为 Hurley 分期 I、II 和 III 期（P<0.01）。在临床检查确定为 I 期分类的患者中，44.7%转为更严重的分期。临床检查表明，44.1%、54.5%和 1.4%的患者将分别维持、增加或减少治疗。对于超声检查，这些百分比分别为 31.5%、67.1%和 1.4%（P<0.01）。临床和超声内部评估者之间的一致性为 22.8%（P<0.01）；内部评估者和外部评估者（放射科医生）之间的超声一致性分别为 94.9%和 81.7%（P<0.01）。
无法检测到直径≤0.1mm 的病变或仅表皮位置的病变。
超声可以通过检测亚临床疾病来改变 HS 的临床分期和治疗管理。
