title: Pain and inflammation in hidradenitis suppurativa correspond to morphological changes identified by high-frequency ultrasound.
abstract: BACKGROUND
  Hidradenitis suppurativa (HS) is an inflammatory skin disease with a chronic intermittent course. The current classification systems used to categorize disease severity provide limited insight into the degree of inflammation and pain, which are key symptoms of the disease.
  
  
  OBJECTIVE
  We sought to investigate the correlation and validity of simple patient- and investigator-assessed items related to inflammation with morphological changes identified by high-frequency ultrasound in HS.
  
  
  METHODS
  Twenty patients with the clinical diagnosis of HS were enrolled in this study. All patients underwent clinical examinations during which one representative inflammatory nodule was selected in each patient based on the anamnestic information, patient experience and clinical presentation. Tenderness and flare activity of the representative nodule were graded by the patients and erythema by the investigator. Subsequently, all patients underwent high-resolution ultrasound scanning of their representative nodule.
  
  
  RESULTS
  We found significant associations between the size of the representative nodule (the diameter in the transverse plane) and patient assessments of flare activity and tenderness. Moreover, we found a marked association between the size of the nodules and investigator assessment of erythema.
  
  
  CONCLUSIONS
  Patient assessments of flare activity and pain, and investigator assessment of erythema are strongly associated with morphological changes identified using ultrasound, suggesting that these patient- and investigator-assessed items might be strong indicators of the degree of present inflammation in HS.
authors.affiliation: Department of Dermatology, Roskilde Hospital, Health Sciences Faculty, University of Copenhagen, Roskilde, Denmark.
authors.forename: K
authors.initials: K
authors.lastname: Zarchi
authors.forename: N
authors.initials: N
authors.lastname: Yazdanyar
authors.forename: S
authors.initials: S
authors.lastname: Yazdanyar
authors.forename: X
authors.initials: X
authors.lastname: Wortsman
authors.forename: G B E
authors.initials: GB
authors.lastname: Jemec
mesh_terms: D000328:Adult; D005260:Female; D017497:Hidradenitis Suppurativa / Q000150:complications* / Q000000981:diagnostic imaging; D006801:Humans; D007249:Inflammation / Q000150:complications* / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000150:complications* / Q000000981:diagnostic imaging; D014463:Ultrasonography; D055815:Young Adult