Comparison of clinical and sonographic scores in hidradenitis suppurativa and proposal of a novel ultrasound scoring system

Gianluca Nazzaro, Emanuela Passoni, Simona Muratori, Chiara Moltrasio, Elena Guanziroli, Mauro Barbareschi, Stefano Veraldi, Angelo V. Marzano

Research output: Contribution to journalArticlepeer-review


BACKGROUND: Hidradenitis suppurativa (HS) is a chronic, inflammatory disease that presents with nodules, abscesses and fistulae affecting the apocrine gland-bearing skin. Since few years, ultrasonography is used to better characterize HS skin lesions but comparison between clinical and sonographic scores has been made only in small series of patients. To assess concordance between clinical and sonographic scores in a larger cohort of HS patients. METHODS: We conducted a retrospective observational study on 140 HS patients comparing two clinical score systems, Hurley and HS-Physical Global Assessment (PGA), with two ultrasonographic scores, sonographic score of hidradenitis suppurativa (SOS-HS) and ultrasonographic HS-PGA, a novel ultrasound scoring system set up by our group. We used the weighted Cohen's Kappa statistic (k) to evaluate the agreement. RESULTS: Agreement between Hurley staging and SOS-HS was found in 61.4% of patients (weighted kappa 0.477), while agreement between clinical and ultrasonography HS-PGA scores was found in 35% of patients (weighted kappa 0.278), both findings suggesting a substantial disagreement. CONCLUSIONS: Our study demonstrated a relevant disagreement between clinical and ultrasonography scores. Ultrasonography discovered non-clinically evident HS lesions, notably fistulae. Taken together, the above findings may support the view, previously suggested in expert panel reports, on the higher sensitivity of ultrasonography compared to clinics in HS.

Original languageEnglish
Pages (from-to)235-239
Number of pages5
JournalItalian Journal of Dermatology and Venereology
Issue number2
Publication statusPublished - Apr 2021


  • Classification
  • Hidradenitis suppurativa
  • Ultrasonography

ASJC Scopus subject areas

  • Dermatology
  • Infectious Diseases


Dive into the research topics of 'Comparison of clinical and sonographic scores in hidradenitis suppurativa and proposal of a novel ultrasound scoring system'. Together they form a unique fingerprint.

Cite this