Hidradenitis suppurativa: advances in diagnostic and therapeutic work-up
Notice bibliographique
Résumé
The aim of the project was to better characterize hidradenitis suppurativa (HS), which is a chronic, recurrent, inflammatory disease with a main diagnostic delay of 7 years and a strong impact in the patient’s quality of life. We evaluated the comorbidities, the complications, the impact in the quality of life, the better diagnostic tools and the treatment outcomes. Considering that the global estimates of prevalence ranges from 0.03% to 4% of the population, the comorbidities and the sex-related differences in HS were analyzed in multicentric studies, collecting 234 and 124 patients respectively. The disease generally appears after puberty and there are only few cases reported in the literature in younger children. The pediatric population was evaluated in collaboration with the Hospital for Sick Children (Toronto, Canada) and other 8 centers in a multicentric retrospective study which included 481 pediatric patients. For evaluating the best way to diagnose and manage HS, we analyzed the role of High Frequency Ultrasound (HFUS) and Ultra High Frequency Ultrasound (UHFUS). The comparison of clinical and ultrasound scores using HFUS in the HS patients was performed in collaboration with the Italian ultrasound working group, showing that the severity of HS assessed only by clinical examination can be underestimated. The UHFUS (Vevo®MD, Visualsonics, Toronto, Canada) is provided by three different probes (22-48-70 MHz) and is characterized by a very high resolution (30 micron). Sonographic criteria for diagnosis HS using HFUS have been described (SOS-HS score), but UHFUS showed the detection of early signs and small sub-clinical changes in HS, which were not previously detectable. These new findings can help to better understand the evolution of the diseases from early to advanced stages and to perform an early diagnosis. The identification of early findings may also allow a better treatment monitoring of the patients and a detailed pre-surgical mapping in patients who are candidate for surgery. We also evaluated the topical treatments, analysing both the pre-surgical lesions and the post-surgical lesions. In particular, in order to better assess the topical management of HS, we described a new tool based on the main principles of the wound bed preparation in wound healing, called HS-TIME. We moreover described the efficacy of adalimumab in 11 adult patients and the case of a young girl suffering from HS, treated with a combination of surgical procedures and adalimumab for 4 years, with good results. The prevalence of HS is underestimated and a correct early diagnosis may help to prevent severe complications. Further investigations studies are needed to determine the efficacy of the new diagnostic tools and the different treatments in HS. In order to promote a multidisciplinary approach on diseases which may be better managed by the use of cutaneous ultrasonography we founded the first international society of cutaneous ultrasound (ISCU). The main aim of the society is to encourage muti-centric, interdisciplinary research projects, based on the ultrasonographic study of skin and subcutaneous tissue.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».