Ultrasound monitoring of hidradenitis suppurativa fistulas in treatment with adalimumab
https://doi.org/10.4081/dr.2025.10124
Accepted: 27 March 2025
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Recently, ultrasound has become a significant tool in studying hidradenitis suppurativa (HS), allowing differentiation between abscesses and fistulas, and assessing various disease features. However, there is still a lack of data on using ultrasound (US) to assess treatment response to medical treatment. The study aims to assess the clinical usefulness of ultrasound in monitoring disease activity in HS patients undergoing treatment with adalimumab over a 52-week period. This research employs a retrospective approach to analyze ultrasound scores related to fibrosis, edema, power-Doppler (PD) signal, and resistive index (RI) at baseline and after 52 weeks of adalimumab treatment. In total, 311 fistulas from 69 patients were included. Multivariate regression analysis showed that PD score and edema were related to IHS4-55 and variations of DLQI and pain-VAS. Furthermore, at baseline, healed and non-healed fistulas were characterized by significant differences in PD signal, fibrosis, edema, and RI. Limitations include the retrospective design of the study, a limited population size, and the absence of a control group. However, our data provide evidence that ultrasound can be a reliable tool for assessing patients’ responses to medical therapies.
Vossen ARJV, van der Zee HH, Prens EP. Hidradenitis Suppurativa: A Systematic Review Integrating Inflammatory Pathways Into a Cohesive Pathogenic Model. Front Immunol 2018;9:2965. DOI: https://doi.org/10.3389/fimmu.2018.02965
Seyed Jafari SM, Hunger RE, Schlapbach C. Hidradenitis Suppurativa: Current Understanding of Pathogenic Mechanisms and Suggestion for Treatment Algorithm. Front Med (Lausanne) 2020;7:68. DOI: https://doi.org/10.3389/fmed.2020.00068
Daoud M, Suppa M, Benhadou F, et al. Overview and comparison of the clinical scores in hidradenitis suppurativa: A real-life clinical data. Front Med (Lausanne). 2023;10:1145152. DOI: https://doi.org/10.3389/fmed.2023.1145152
Wortsman X. Update on Ultrasound Diagnostic Criteria and New Ultrasound Severity and Activity Scorings of Hidradenitis Suppurativa: Modified SOS-HS and US-HSA. J Ultrasound Med 2024;43:207-13. DOI: https://doi.org/10.1002/jum.16351
Krajewski PK, Jfri A, Ochando-Ibernón G, Martorell A. Ultrasonographic railway sign in tunnels as a new independent risk factor of adalimumab failure in hidradenitis suppurativa. J Am Acad Dermatol 2023;88:732-4. DOI: https://doi.org/10.1016/j.jaad.2022.08.064
Caposiena Caro RD, Solivetti FM, Candi E, Bianchi L. Clinical and Power-Doppler ultrasound features related with persistence of fistulous tracts under treatment with adalimumab in hidradenitis suppurativa: 4 years of follow-up. Dermatol Ther 2021;34:e14804. DOI: https://doi.org/10.1111/dth.14804
Nazzaro G, Calzari P, Passoni E, et al. Vascularization and fibrosis are important ultrasonographic tools for assessing response to adalimumab in hidradenitis suppurativa: Prospective study of 32 patients. Dermatol Ther 2021;34:e14706. DOI: https://doi.org/10.1111/dth.14706
Chiricozzi A, Giovanardi G, Garcovich S, et al. Clinical and Ultrasonographic Profile of Adalimumab-treated Hidradenitis Suppurativa Patients: A Real-life Monocentric Experience. Acta Derm Venereol 2020;100:adv00172. DOI: https://doi.org/10.2340/00015555-3520
Caposiena Caro RD, Cannizzaro MV, Tartaglia C, Bianchi L. Clinical response rate and flares of hidradenitis suppurativa in the treatment with adalimumab. Clin Exp Dermatol 2020;45:438-44. DOI: https://doi.org/10.1111/ced.14127
Caposiena Caro RD, Cannizzaro MV, DI Raimondo C, et al. Long-term efficacy and safety of adalimumab on a severe case of hidradenitis suppurativa. Ital J Dermatol Venerol 2021;156:101-2. DOI: https://doi.org/10.23736/S2784-8671.18.06194-1
Lacarrubba F, Dini V, Napolitano M, et al.; Italian Ultrasound Working Group. Ultrasonography in the pathway to an optimal standard of care of hidradenitis suppurativa: the Italian Ultrasound Working Group experience. J Eur Acad Dermatol Venereol 2019;33 (Suppl 6):10-4. DOI: https://doi.org/10.1111/jdv.15847
Caposiena Caro RD, Solivetti FM, Bianchi L. Power Doppler ultrasound assessment of vascularization in hidradenitis suppurativa lesions. J Eur Acad Dermatol Venereol 2018;32:1360-7. DOI: https://doi.org/10.1111/jdv.14745
Wortsman X, Castro A, Figueroa A. Color Doppler ultrasound assessment of morphology and types of fistulous tracts in hidradenitis suppurativa (HS). J Am Acad Dermatol 2016;75:760-7. DOI: https://doi.org/10.1016/j.jaad.2016.05.009
Wortsman X, Reyes-Baraona F, Ramirez-Cornejo C, et al. Can Ultrasound Examinations Generate Pain in Hidradenitis Suppurativa Patients? Results from a Multicentric Cross-Sectional Study. Dermatology 2023;239:277-82. DOI: https://doi.org/10.1159/000526537
Steele H, Cheng J, Willicut A, et al. TNF superfamily control of tissue remodeling and fibrosis. Front Immunol. 2023;14:1219907. DOI: https://doi.org/10.3389/fimmu.2023.1219907
Izadi D, Layton TB, Williams L, et al. Identification of TNFR2 and IL-33 as therapeutic targets in localized fibrosis. Sci Adv 2019;5:eaay0370. DOI: https://doi.org/10.1126/sciadv.aay0370
Moran B, Sweeney CM, Hughes R, et al. Hidradenitis Suppurativa Is Characterized by Dysregulation of the Th17:Treg Cell Axis, Which Is Corrected by Anti-TNF Therapy. J Invest Dermatol 2017;137:2389-95. DOI: https://doi.org/10.1016/j.jid.2017.05.033
Grand D, Frew JW, Navrazhina K, Krueger JG. Doppler ultrasound-based noninvasive biomarkers in hidradenitis suppurativa: evaluation of analytical and clinical validity. Br J Dermatol 2021;184:688-96. DOI: https://doi.org/10.1111/bjd.19343
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