Defining Fistular Patterns in Hidradenitis Suppurativa: Impact on the Management. Issue 10 (October 2019)

• Record Type: Journal Article
• Authors: Martorell, Antonio; Giovanardi, Giulia; Gomez-Palencia, Pilar; Sanz-Motilva, Virginia
• Is Part Of: Dermatologic surgery. Volume 45:Issue 10(2019)
• Publication Date: 2019-10
• Subjects: Skin -- Surgery -- Periodicals; Skin -- Diseases -- Surgery -- Periodicals; 617.477
• DOI: 10.1097/DSS.0000000000001916
• Languages: English
• ISSNs: 1076-0512

Abstract

Abstract : BACKGROUND: Recent studies suggest that there are different fistular subtypes in hidradenitis suppurativa (HS) patients who are associated with variable therapeutic outcomes. OBJECTIVE: To describe clinical and ultrasound features that characterize the different fistular patterns in HS and to evaluate the response to medical therapies. METHODS: 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. RESULTS: 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. CONCLUSION: 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.