Hidradenitis suppurativa: Current understanding, diagnostic and surgical challenges, and developments in ultrasound application

Background Hidradenitis suppurativa (HS) is debilitating, costly, chronic disease for which no cure exists and which often precipitates greater health concerns. While we are making advances in understanding, HS remains an area of attention which is evidenced by a 400% increase in research studies involving HS in the past 5 years. This includes research regarding the advantages and limitations of ultrasound (US) imaging and its ability to enhance the surgical treatment and medical management of HS. Herein, we describe the diagnostic and surgical obstacles that HS presents, the foremost of which is detection of subclinical information, and perform an in-depth synthesis of current knowledge regarding the use of US imaging to mitigate these obstacles. Materials and Methods A comprehensive literature review of US imaging in HS patients and a supplementary review of the current state of HS were conducted. Conclusion Ultrasound imaging is a powerful tool in the diagnosis, monitoring, clinical management, and preoperative assessment of HS. However, it also has relevant limitations that necessitate additional consideration. Significance Hidradenitis suppurativa is a disabling skin disease that presents a diagnostic and surgical challenge. The invaluable advantages and relevant limitations that US imaging offers are beginning to be understood, leading to standardization and increased implementation. US imaging has the potential to drastically improve patient care and merits further attention.