Hidradenitis suppurativa: Morphologic and vascular study of nodular inflammatory lesions by means of optical coherence tomography

Hidradenitis suppurativa (HS) is an inflammatory disease characterized by a recurrent‐remission trend and clinical lesions that range from asymptomatic to inflamed, deep‐seated nodules with scarring and suppuration. The aim of our study was to identify morphologic and vascular features of HS nodules by means of dynamic optical coherence tomography (D‐OCT) and to define if they are correlated to patient endotype and risk of disease progression. A set of standardized clinical pictures and D‐OCT images were acquired from 57 inflammatory nodules of 40 patients affected by HS. A set of 20 clinical and D‐OCT images were acquired from 20 healthy volunteers as a control group. The comparison of D‐OCT features among HS and control group was analysed. The correlation between HS patient endotype and D‐OCT features of the lesions was calculated. D‐OCT enabled to identify vascular and morphological aspects characterizing HS nodular inflammatory lesions. In addition, several D‐OCT features were significantly different among distinct disease endotypes. The characterization of HS nodular inflammatory lesions through D‐OCT, corresponding to blood vessel dilation and inflammatory associated hyper‐vascularization, may have important clinical consequences in the assessment of HS risk of progression, therapeutic decisions and treatment efficacy monitoring.