Ultrasound monitoring of hidradenitis suppurativa fistulas in treatment with adalimumab

Recently, ultrasound has emerged as an important tool for studying hidradenitis suppurativa (HS), enabling differentiation between abscesses and fistulas and the assessment of various disease features. However, data on the use of ultrasound to evaluate treatment response to medical therapy remain limited. This study aims to evaluate the clinical utility of ultrasound in monitoring disease activity in HS patients treated with adalimumab over a 52-week period. This research employs a retrospective approach to analyze ultrasound scores related to fibrosis, edema, power-Doppler (PD) signal, and resistive index (RI) at baseline and after 52 weeks of adalimumab treatment. In total, 311 fistulas from 69 patients were included. Multivariate regression analysis revealed that PD score and edema were associated with the International Hidradenitis Suppurativa Severity Score System (IHS4)-55, as well as with changes in the Dermatology Life Quality Index (DLQI) and pain Visual Analogue Scale (VAS) scores. Moreover, at baseline, healed and non-healed fistulas showed significant differences in PD signal, fibrosis, edema, and RI. Limitations include the retrospective design of the study, a limited population size, and the absence of a control group. However, our data provide evidence that ultrasound can be a reliable tool for assessing patients’ responses to medical therapies.