Hidradenitis Suppurativa – A Diagnostic Atlas

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

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 Verzi, 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