Nodular Inflammatory Lesions of HS Show Blood Vessel Dilation, Hypervascularization

In a recent study published in Experimental Dermatology, nodular inflammatory lesions in hidradenitis suppurativa (HS) examined using dynamic optical coherence tomography (D-OCT) demonstrate blood vessel dilation and inflammatory associated hypervascularization.

Researchers aimed to assess and describe D-OCT morphological features of nodular inflammatory HS lesions and to determine whether different D-OCT features are associated with a distinct phenotype of the disease in a retrospective case-control study of patients with HS and matched controls.

The study was performed at the dermatology department of the University of Modena and Reggio Emilia between January 2018 and June 2021. Standardized clinical pictures and D-OCT images were taken from 57 inflammatory nodules of 40 patients with HS and 20 inflammatory nodules of 20 healthy volunteers as a control. D-OCT features were compared among the patients with HS and healthy volunteers and a correlation between the two was calculated.

D-OCT analysis showed that HS nodules are morphologically and functionally different from healthy skin. HS nodules contain a dome shape with one or more enlarged infundibula at the top with amorphous keratin material inside. In addition, hyperechogenic inflammatory amorphous material was observed inside the epidermis or superficial dermis. HS nodules also have increased vascularity compared with healthy skin.

“To conclude, the characterization of HS nodules through D-OCT image analysis allows to identify specific features associated with infundibular alterations, inflammation and tissue remodeling with neovascularization,” concluded the study authors. “The microscopic and functional analysis of early HS lesions with D-OCT may have important clinical consequences for patient assessment and management, and to non-invasively monitor treatment efficacy, in order to prevent scarring and disease progression,” they added.

Reference
Manfredini M, Chello C, Ciardo S, et al. Hidradenitis suppurativa: morphologic and vascular study of nodular inflammatory lesions by means of optical coherence tomography. Exp Dermatol. Published online March 9, 2022. doi:10.1111/exd.14560