Work

High-frequency ultrasound in the diagnosis of Hidradenitis suppurativa: experience from the Bulgarian HS Expert Centre

Year: 2025

Type: article

Abstract: Introduction: Hidradenitis suppurativa (HS) is an immune-mediated, autoinflammatory skin disease with different clinical manifestations.Traditional clinical examination may not assess HS true extent, while high-frequency ultrasound can detect subclinical lesions, influencing severity assessments.Aim: To compare the clinical severity of HS with the ultrasonography-based staging, and explore relationships between demographic data, risk factors and clinical phenotypes.Material and methods: An ongoing pilot study included 98 patients of the Bulgarian HS Expert Centre.Informed consent and epidemiological data were collected.Patients were categorized into disease duration groups (short/ long) and classified by phenotype.Clinical severity was assessed through Hurley, IHS4, and HS-PGA staging systems and by ultrasound using SOS-HS, US IHS4, and US HS-PGA scales.Results: The study cohort was predominately male (74.5%) with a mean age of 36.69 years, average disease duration of 7.6 years and prevalence of the regular phenotype (53%).Age and disease duration correlated with Hurley stage (p < 0.05), but not with SOS-HS severity.Comorbidities correlated with disease duration (ρ = 0.256, p = 0.01), and the follicular-furunculous phenotype was associated with the females (p = 0.04).Clinical and ultrasound assessments showed strong correlations, although ultrasound showed higher severity scores (ρ = 0.42 to 0.92, p < 0.05), as well as significant differences across the phenotypes.Conclusions: HS is often underestimated due to delayed diagnosis and atypical presentations.Combining clinical and ultrasound assessments can provide more accurate staging.A multidisciplinary approach in expert centres can enhance diagnosis, treatment and monitoring.

Source: Advances in Dermatology and Allergology

DOI: 10.5114/ada.2025.151138

Authors: Gavrail Poterov, Tanya Gancheva, Karen Manuelyan, Evgeniya Hristakieva

Institution: Trakia University

Language: English

Topic: Hidradenitis Suppurativa and Treatments

Subfield: Dermatology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $472