To explore a broader definition of active tunnels in hidradenitis suppurativa (HS) by correlating clinical signs with colour Doppler ultrasound findings, aiming to improve recognition of inflammatory activity.
Key Findings:
Doppler activity frequently persists in non-draining tunnels, indicating ongoing inflammatory processes that may require intervention.
Pain associated with erythema or induration reliably identifies Doppler-active tunnels without purulent discharge, suggesting a need for revised diagnostic criteria.
Dermal (type A) tunnels may represent early, non-draining but Doppler-active stages of tunnel disease, highlighting the potential for early treatment.
Interpretation:
A clinical, inflammation-centered definition of tunnel activity may enable earlier identification of active tunnels, supporting timely treatment decisions and improving patient outcomes.
Limitations:
Doppler signal is an indirect, operator-dependent marker, which may introduce variability in results.
Tunnels cannot be considered fully independent observations due to multiple evaluations within the same patient, potentially skewing data.
Conclusion:
The study suggests that current definitions of tunnel activity may underestimate inflammatory activity in HS, warranting further prospective validation to enhance clinical practice.
