title: Color Doppler ultrasound assessment of morphology and types of fistulous tracts in hidradenitis suppurativa (HS).
abstract: BACKGROUND
  Fistulous tracts in hidradenitis suppurativa (HS) are key signs of severity and their clinical evaluation alone may be limited for assessing their presence and morphology. There is also a need to determine the factors that allow reversibility of the anatomic changes in HS.
  
  
  OBJECTIVE
  We sought to categorize fistulous tracts in HS.
  
  
  METHODS
  A retrospective study of color Doppler ultrasound images of cases with positive clinical and sonographic criteria of HS with fistulous tracts was performed. The sonographic staging of HS, location, and anatomic characteristics of the tracts were registered and graded. Statistical analysis for correlating variables was performed using bivariate and multivariate studies.
  
  
  RESULTS
  In all, 52 patients presenting 96 fistulous tracts met the criteria. Morphology was defined and a sonographic classification into 3 types of fistulae was developed. Type 3 concentrated 71% of the cases presenting communicating tracts, and type 2, 29%. Types 2 and 3 represented 63% of patients with multiple fistulous tracts. Fistulous tracts types 2 and 3 were significantly correlated with age 35 years or older and groin location.
  
  
  CONCLUSIONS
  Ultrasound cannot detect lesions less than 0.1 mm.
  
  
  CONCLUSIONS
  Fistulous tracts in HS can be categorized using ultrasound, which may support earlier and more precise management.
authors: Departments of Radiology and Dermatology, Institute for Diagnostic Imaging and Research of the Skin and Soft Tissues, Clinica Servet, Faculty of Medicine, University of Chile, Santiago, Chile. Electronic address: xworts@yahoo.com.
authors: Ximena
authors: X
authors: Wortsman
authors: Office for Clinical Research Support, Hospital Clinico Universidad de Chile, Faculty of Medicine, University of Chile, Santiago, Chile.
authors: Ariel
authors: A
authors: Castro
authors: Department of Dermatology, Hospital Clinico Universidad de Chile, Faculty of Medicine, University of Chile, Santiago, Chile.
authors: Andres
authors: A
authors: Figueroa
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D002677:Chile; D015331:Cohort Studies; D017577:Cutaneous Fistula / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000473:pathology*; D005260:Female; D017497:Hidradenitis Suppurativa / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000473:pathology*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011379:Prognosis; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D017678:Sex Distribution; D018608:Ultrasonography, Doppler / Q000379:methods*; D055815:Young Adult
keywords: dermatologic ultrasound; fistula hidradenitis; hidradenitis; hidradenitis sonography; hidradenitis suppurativa; hidradenitis suppurativa imaging; hidradenitis suppurativa ultrasound; hidradenitis ultrasound; skin ultrasound; tunnels hidradenitis