Hidradenitis Suppurativa

Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease that can significantly affect patient quality of life. It presents with cutaneous nodules, abscesses, and tracts that are painful and recurrent. The lesions produce foul-smelling discharge and mainly affect intertriginous areas. HS has an estimated overall prevalence in the range of 0.1–2%. A diagnostic delay of up to 7–10 years is typical. The diagnosis of HS is usually made based on clinical findings. However, with cutaneous ultrasound, we can see incipient signs in these images that precede clinical onset, and we can detect deep lesions that would otherwise be clinically unsuspected. The Hurley staging system is still widely used in grading severity and is complemented and enhanced by the ultrasound Hurley scale. HS is associated with metabolic syndrome, other cardiovascular disease risk factors, depression, and substance use disorders. It has also been associated with other autoinflammatory diseases, such as inflammatory bowel disease, psoriasis, and spondyloarthropathy. HS is a complex disease that requires an interdisciplinary approach to ensure the best outcomes in severe cases.