May Lee Marco, Naldi Luigi, Piraccini Bianca Maria, Starace Michela, Alessandrini Aurora, Sechi Andrea
Section of Dermatology, Department of Clinical and Experimental Medicine, University of Parma, Parma, Italy.
Dermatology Unit, Ospedale San Bortolo, Vicenza, Italy.
Skin Appendage Disord. 2023 Aug;9(4):275-279. doi: 10.1159/000530630. Epub 2023 Jun 7.
Dissecting cellulitis (DC) is a rare neutrophilic dermatosis that leads to cicatricial alopecia. Although DC and Hidradenitis suppurativa (HS) have similar characteristics, their association remains poorly understood.
In this prospective observational study, we used trichoscopy to identify subclinical signs of DC in male patients aged 18 years or older, presenting with HS. The objective of this study was to use trichoscopy to identify subclinical signs of DC in patients with confirmed diagnosis of HS.
In this prospective, monocentric, observational study, we used trichoscopy to identify subclinical signs of DC in male patients aged 18 years or older, presenting with HS for their initial visit at our HS outpatient clinic from February 1, 2022, to January 31, 2023.
Of the 23 male patients with HS, 8 (35%) had subclinical trichoscopy findings consistent with DC. The most frequent location was the vertex (6/8), and the majority of patients had early/inflammatory trichoscopic signs of DC (5/8). Additionally, patients with trichoscopic findings consistent with DC had a higher Hurley stage and the International Hidradenitis Suppurativa Severity Score System (IHS4). Among the cases with trichoscopic findings compatible with DC, the majority (6/8) were classified as having a "follicular" HS according to the Canoui-Poitrine classification. Patients were treated according to European S1 guidelines on HS.
This is the first study to evaluate subclinical DC findings in HS patients using trichoscopy. Although the trichoscopic findings of DC are heterogeneous, the use of this non-invasive technique, in conjunction with clinical evaluation, can improve diagnostic accuracy and lead to earlier diagnosis. These findings suggest a potential association between HS and DC, indicating the need for further studies to evaluate this relationship.
切割性蜂窝织炎（DC）是一种罕见的嗜中性皮肤病，可导致瘢痕性脱发。尽管DC和化脓性汗腺炎（HS）具有相似的特征，但它们之间的关联仍知之甚少。
在这项前瞻性观察研究中，我们使用皮肤镜检查来识别18岁及以上患有HS的男性患者中DC的亚临床体征。本研究的目的是使用皮肤镜检查来识别确诊为HS的患者中DC的亚临床体征。
在这项前瞻性、单中心观察研究中，我们使用皮肤镜检查来识别2022年2月1日至2023年1月31日期间首次到我们的HS门诊就诊的18岁及以上患有HS的男性患者中DC的亚临床体征。
在23例患有HS的男性患者中，8例（35%）有与DC一致的亚临床皮肤镜检查结果。最常见的部位是头顶（6/8），大多数患者有DC的早期/炎症性皮肤镜体征（5/8）。此外，皮肤镜检查结果与DC一致的患者Hurley分期和国际化脓性汗腺炎严重程度评分系统（IHS4）更高。在皮肤镜检查结果与DC相符的病例中，根据卡努伊 - 普瓦林分类，大多数（6/8）被归类为“滤泡性”HS。患者按照欧洲HS S1指南进行治疗。
这是第一项使用皮肤镜检查评估HS患者中DC亚临床发现的研究。尽管DC的皮肤镜检查结果具有异质性，但使用这种非侵入性技术并结合临床评估，可以提高诊断准确性并实现更早诊断。这些发现提示HS和DC之间可能存在关联，表明需要进一步研究来评估这种关系。
