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

Foreword, ix

1 Introduction, 1
Giuseppe Micali, Maria Rita Nasca, and Maria Letizia Musumeci

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, 3

2.2.3 Immunity, 4

3 Clinical features and diagnostic clues, 7
Maria Letizia Musumeci, Maria Rita Nasca, Piera Catalfo, Karishma Bhatt, Federica Dall’Oglio, 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 phenotypes, 27

3.3 Diagnostic clues, 27

4 Histopathology, 29
Franco Rongioletti

4.1 Histopathological features, 29

4.2 Immunohistochemistry, 37

4.3 Histological differential diagnoses, 37

5 Classification and severity scales, 39
Giuseppe Monfrecola and Matteo Megna

6 Correlation between severity and its impact on quality of life, 47
Nevena Skroza, Alessandra Mambrin, Nicoletta Bernardini, and Maria Concetta Potenza

6.1 Quality of life questionnaires, 47

6.1.1 Dermatology Life Quality Index, 47

6.1.2 Pain Visual Analogue Scale, 49

6.1.3 Other quality of life questionnaires, 49

6.1.4 Sexual dysfunction questionnaires, 52

7 Comorbidities and complex syndromes, 55
Gabriella Fabbrocini and Valerio De Vita

7.1 Comorbidities, 55

7.1.1 Metabolic syndrome, 55

7.1.2 Inflammatory bowel disease, 58

7.1.3 Pyoderma gangrenosum, 59

7.1.4 Acne, 60

7.1.5 Pilonidal cyst, 60

7.1.6 Psoriasis, 62

7.1.7 Other disorders, 62

7.2 Complex syndromes, 63

7.2.1 PASH, PsAPASH, PAPASH, PASS, and SAPHO syndromes, 63

7.2.2 Follicular occlusion syndromes, 63

8 Complications, 65
Teresa Oranges, Valentina Dini, Andrea Chiricozzi, Salvatore Panduri, and Marco Romanelli

9 Ultrasound imaging, 69
Antonio Martorell

9.1 Staging, 74

9.1.1 Sonographic scoring of HS (SOS-HS), 74

9.2 Evaluation of the inflammatory activity, 76

9.3 Monitoring, 76

10 Radiological imaging, 79
Giuseppe Petrillo, Stefano Palmucci, and Claudia Trombatore

10.1 Magnetic resonance imaging, 79

10.2 Computed tomography, 81

10.3 Positron emission tomography, 85

11 Skin imaging: dermatoscopy, 87
Francesco Lacarrubba, Anna Elisa Verzì, Aurora Tedeschi, Federica Fiorentini, and Giuseppe Micali

12 Differential diagnosis, 91
Stefano Veraldi, Elena Guanziroli, and Mauro Barbareschi

13 Conclusions, 101
Giuseppe Micali

Index, 103

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