Hidradenitis Suppurativa: A Diagnostic Atlas

Hidradenitis Suppurativa: A Diagnostic Atlas provides a unique visual aid to the diagnosis of Hidradenitis Suppurativa (HS), also known as "acne inversa." The book covers the epidemiology and pathogenesis of the disease, its typical presentation, differences in manifestations of cutaneous versus systemic instances, and considerations for clinical and histopathological differential diagnosis. Guidance is also provided for the classification of disease severity and for managing the impact of HS on the patient′s quality of life.

The book is packed with high–quality, full–color clinical images for each of the most common HS diagnostic imaging techniques, such as videodermatoscopy, ultrasound, computed tomography, and magnetic resonance imaging. As a clinical atlas, it helps dermatologists with differential diagnoses and correct assessments of disease severity, as well as possible complications of the condition. The book:

Is highly focused on acne inversa, which can have a debilitating impact on quality of life Includes over 200 outstanding diagnostic clinical images Covers all imaging modalities used in the diagnosis and management of Hidradenitis Suppurativa

This book is a key resource for dermatologists, dermatopathologists, and dermatology nurses working with patients with HS.

List of contributors vii

1 Introduction 1
Gregor Jemec

2 Epidemiology and pathogenesis 3
Vincenzo Bettoli and Giulia Ruina

2.1 Epidemiology 3

2.2 Pathogenesis 3

2.2.1 Genetic factors 3

2.2.2 Environmental factors 4

2.2.3 Immunity 4

References 4

3 Clinical features and diagnostic clues 7
Maria Letizia Musumeci, Maria Rita Nasca, Piera Catalfo, Karishma Bhatt, and Giuseppe Micali

3.1 Cutaneous findings 7

3.1.1 Typical cutaneous lesions 13

3.1.2 Other cutaneous lesions 25

3.2 Alternative clinical presentations 27

3.3 Diagnostic clues 27

References 28

4 Histopathology 29
Franco Rongioletti

4.1 Histopathological features 29

4.2 Immunohistochemistry 33

4.3 Histological differential diagnoses 34

References 34

5 Classification and severity scales 35
Giuseppe Monfrecola and Matteo Megna

References 41

6 Correlation between severity and its impact on quality of life 43
Nevena Skroza and Maria Concetta Potenza

6.1 Quality of life questionnaires 43

6.1.1 Dermatology Life Quality Index 43

6.1.2 Pain Visual Analogue Scale 45

6.1.3 Other quality of life questionnaires 45

6.1.4 Sexual dysfunction questionnaires 48

References 48

7 Comorbidities and complex syndromes 51
Gabriella Fabbrocini and Valerio De Vita

7.1 Comorbidities 51

7.1.1 Metabolic syndrome 51

7.1.2 Inflammatory bowel disease 54

7.1.3 Pyoderma gangrenosum 54

7.1.4 Acne 55

7.1.5 Pilonidal cyst 56

7.1.6 Psoriasis 56

7.1.7 Other disorders 57

7.2 Complex syndromes 57

7.2.1 PASH PsAPASH PAPASH PASS and SAPHO syndromes 58

7.2.2 Follicular occlusion syndromes 58

References 58

8 Complications 61
Teresa Oranges, Valentina Dini, Andrea Chiricozzi, Salvatore Panduri, and Marco Romanelli

References 64

9 Ultrasound imaging 65
Antonio Martorell

9.1 Staging 69

9.1.1 Sonographic scoring of HS (SOS–HS) 71

9.2 Evaluation of the inflammatory activity 71

9.3 Monitoring 71

References 72

10 Radiological Imaging 73
Giuseppe Petrillo, Stefano Palmucci, and Claudia Trombatore

10.1 Magnetic resonance imaging 73

10.2 Computed tomography 75

10.3 Positron emission tomography 79

References 79

11 Skin imaging: dermatoscopy and videodermatoscopy 81
Giuseppe Micali

References 84

12 Differential diagnosis 85
Stefano Veraldi, Elena Guanziroli, and Mauro Barbareschi

References 94

13 Conclusions 95
Giuseppe Micali

References 95

Index 97

Giuseppe Micali, MD
Chair, Professor of Dermatology
Department of Dermatology, University of Catania, Italy