Preoperative Tunnel Measurement in Hidradenitis Suppurativa: Comparison of Palpation and Ultrasound

TL;DR

This study compares palpation and ultrasound for measuring tunnels in hidradenitis suppurativa, finding ultrasound more accurate.

Contribution

The study demonstrates that high-frequency ultrasound provides more precise tunnel length measurements than palpation in hidradenitis suppurativa.

Findings

USG measurements were on average 10.3 mm longer than palpation measurements.

Axillary lesions were most common, followed by inguinal and sacral regions.

Most lesions were classified as Hurley stage 2 or 3 with a median IHS4 score of 8.

Abstract

Background/Objectives: The accurate measurement of tunnel lengths in hidradenitis suppurativa (HS) is critical for surgical planning. This study aimed to evaluate the agreement between palpation and high-frequency ultrasound (USG) for assessing tunnel lengths in HS patients. Methods: This prospective study included patients who underwent the surgical excision of tunnels between May 2024 and July 2024 at a referral dermatology clinic. Tunnel lengths were measured preoperatively using palpation and USG. Clinical and demographic data, including lesion localization and disease severity, were prospectively recorded and analyzed. Results: This study analyzed 121 lesions from patients undergoing surgical excision for HS. Tunnel lengths measured by palpation had a median of 30 mm [IQR 18–40], while USG measurements had a median of 36 mm [IQR 24–51.5], with USG identifying tunnels 10.3 mm longer on average (95% CI: 8.2–12.3). Axillary lesions were most frequent (53.7%), followed by inguinal (32.2%) and sacral regions (6.6%). Most lesions were classified as Hurley stage 2 (59.5%) and stage 3 (37.2%), with a median IHS4 score of 8 [IQR 7–11]. Conclusions: High-frequency USG offers greater precision than palpation in measuring tunnel lengths, indicating its potential to enhance disease assessments in HS.

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