Skip to main content

Ultrasound-Assisted Hidradenitis Suppurativa Procedures

  • Chapter
  • First Online:
Textbook of Dermatologic Ultrasound


Skin ultrasound is a useful tool for diagnosing and staging hidradenitis suppurativa (HS). Numerous studies confirmed that the clinical evaluation underestimates the severity and count of HS lesions compared to the ultrasound evaluation.

One of the main advantages of ultrasound, apart from its safety, is its ability to show the structure to be treated in real time. Also, its portability allows us to move the equipment to the operating room or a procedure room. All of this makes ultrasound the ideal technical complement to planning surgical procedures and guiding intralesional infiltration of anti-inflammatory drugs in HS.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Subscribe and save

Springer+ Basic
EUR 32.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or eBook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
USD 99.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 129.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 199.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Similar content being viewed by others


  1. Martorell A, García-Martínez FJ, Jiménez-Gallo D, et al. An update on Hidradenitis Suppurativa (part I): epidemiology, clinical aspects, and definition of disease severity. Actas Dermosifiliogr. 2015;106:703–15.

    Article  CAS  PubMed  Google Scholar 

  2. Jemec GBE. Clinical practice. Hidradenitis suppurativa. N Engl J Med. 2012;366:158–64.

    Article  CAS  PubMed  Google Scholar 

  3. Shahi V, Alikhan A, Vazquez BG, et al. Prevalence of hidradenitis suppurativa: a population-based study in Olmsted County, Minnesota. Dermatology. 2014;229:154–8.

    Article  PubMed  Google Scholar 

  4. Revuz JE, Canoui-Poitrine F, Wolkenstein P, et al. Prevalence and factors associated with hidradenitis suppurativa: results from two case-control studies. J Am Acad Dermatol. 2008;59:596–601.

    Article  PubMed  Google Scholar 

  5. Zouboulis CC, Desai N, Emtestam L, et al. European S1 guideline for the treatment of hidradenitis suppurativa/acne inversa. J Eur Acad Dermatol Venereol. 2015;29:619–44.

    Article  CAS  PubMed  Google Scholar 

  6. García-Martínez FJ, Pascual JC, López-Martín I, et al. Update of hidradenitis suppurativa in primary care. SEMERGEN. 2017;43:34–42.

    Article  PubMed  Google Scholar 

  7. Martorell A, Alfageme Roldán F, Vilarrasa Rull E, et al. Ultrasound as a diagnostic and management tool in hidradenitis suppurativa patients: a multicentre study. J Eur Acad Dermatol Venereol. 2019;33:2137–42.

    Article  CAS  PubMed  Google Scholar 

  8. Zarchi K, Yazdanyar N, Yazdanyar S, et al. Pain and inflammation in hidradenitis suppurativa correspond to morphological changes identified by high-frequency ultrasound. J Eur Acad Dermatol Venereol. 2015;29:527–32.

    Article  CAS  PubMed  Google Scholar 

  9. Wortsman X, Moreno C, Soto R, et al. Ultrasound in-depth characterization and staging of hidradenitis suppurativa. Dermatol Surg. 2013;39:1835–42.

    Article  CAS  PubMed  Google Scholar 

  10. Grand D, Frew JW, Navrazhina K, et al. Doppler ultrasound-based noninvasive biomarkers in hidradenitis suppurativa: evaluation of analytical and clinical validity. Br J Dermatol. 2021;184(4):688–96.

    Article  CAS  PubMed  Google Scholar 

  11. Del Cura JL, Zabala R, Corta I. Intervencionismo guiado por ecografía: lo que todo radiólogo debe conocer. Radiologia. 2010;52:198–207.

    Article  PubMed  Google Scholar 

  12. Riccabona M. Basics, principles, techniques and modern methods in paediatric ultrasonography. Eur J Radiol. 2014;83:1487–94.

    Article  PubMed  Google Scholar 

  13. García-Martínez FJ, Muñoz-Garza FZ, Hernández-Martín A. Ecografía en dermatología pediátrica. Actas Dermosifiliogr. 2015;106(Suppl):76–86.

    Article  PubMed  Google Scholar 

  14. Maghfour J, Kuraitis D, Murina A. Intralesional 5-fluorouracil for treatment of non-melanoma skin cancer: a systematic review. J Drugs Dermatol. 2021;20:192–8.

    Article  PubMed  Google Scholar 

  15. Harrington KJ, Michielin O, Malvehy J, et al. A practical guide to the handling and administration of talimogene laherparepvec in Europe. Onco Targets Ther. 2017;10:3867–80.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Queen D, Samie FH, Zeitouni NC. How we do it: administration guide for Intralesional immunotherapy with Talimogene Laherparepvec (T-VEC) for advanced melanoma. Dermatol Surg. 2020;46:1455–7.

    Article  CAS  PubMed  Google Scholar 

  17. García-Martínez FJ, Vilarrasa Rull E, Salgado-Boquete L, et al. Intralesional corticosteroid injection for the treatment of hidradenitis suppurativa: a multicenter retrospective clinical study. J Dermatolog Treat. 2021;32(3):286–90.

    Article  CAS  PubMed  Google Scholar 

  18. Fajgenbaum K, Crouse L, Dong L, et al. Intralesional triamcinolone may not be beneficial for treating acute Hidradenitis Suppurativa lesions: a double-blind, randomized, placebo-controlled trial. Dermatol Surg. 2020;46:685–9.

    Article  CAS  PubMed  Google Scholar 

  19. Riis PT, Boer J, Prens EP, et al. Intralesional triamcinolone for flares of hidradenitis suppurativa (HS): a case series. J Am Acad Dermatol. 2016;75:1151–5.

    Article  CAS  PubMed  Google Scholar 

  20. Álvarez P, García-Martínez FJ, Poveda I, et al. Intralesional triamcinolone for fistulous tracts in hidradenitis suppurativa: an uncontrolled prospective trial with clinical and ultrasonographic follow-up. Dermatology. 2020;236:46–51.

    Article  CAS  PubMed  Google Scholar 

  21. Cuenca-Barrales C, Salvador-Rodríguez L, Arias-Santiago S, et al. Pre-operative ultrasound planning in the surgical management of patients with hidradenitis suppurativa. J Eur Acad Dermatol Venereol. 2020;34:2362–7.

    Article  CAS  PubMed  Google Scholar 

  22. Garelik J, Babbush K, Ghias M, et al. Efficacy of high-dose intralesional triamcinolone for hidradenitis suppurativa. Int J Dermatol. 2021;60:217–21.

    Article  CAS  PubMed  Google Scholar 

  23. Dautriche CN, Mamalis A, Lai Y, et al. Tumescent triamcinolone infiltration: a new approach for the management of recalcitrant hidradenitis suppurativa. JAAD Case Rep. 2020;6:1310–2.

    Article  PubMed  PubMed Central  Google Scholar 

  24. Fania L, Clemente A, Sampogna F, et al. Intralesional ultrasound-guided combined treatment with triamcinolone plus lincomycin in hidradenitis suppurativa: a pilot study. Dermatol Ther. 2020:33, e13901.

  25. Suárez Valladares MJ, Eiris Salvado N, Rodríguez Prieto MA. Treatment of hidradenitis suppurativa with intralesional photodynamic therapy with 5-aminolevulinic acid and 630 nm laser beam. J Dermatol Sci. 2017;85:241–6.

    Article  CAS  PubMed  Google Scholar 

  26. Agut-Busquet E, Romaní J, Gilaberte Y, et al. Photodynamic therapy with intralesional methylene blue and a 635 nm light-emitting diode lamp in hidradenitis suppurativa: a retrospective follow-up study in 7 patients and a review of the literature. Photochem Photobiol Sci. 2016;15:1020–8.

    Article  CAS  PubMed  Google Scholar 

  27. Luis SR, Salvador AS, Alejandro ML. Ultrasound-assisted intralesional corticosteroid infiltrations for patients with hidradenitis suppurativa. Sci Rep. 2020;10:13363.

    Article  CAS  PubMed Central  Google Scholar 

  28. Caposiena Caro RD, Tartaglia C, Pensa C, et al. Intralesional therapy under ultrasound guidance in hidradenitis suppurativa: the importance of ultrasound evaluation. Dermatol Ther. 2020:33, e14116.

  29. Scheinfeld N. Hidradenitis suppurativa: a practical review of possible medical treatments based on over 350 hidradenitis patients. Dermatol Online J. 2013;19:1.

    PubMed  Google Scholar 

  30. Martorell A, Wortsman X, Alfageme F, et al. Ultrasound evaluation as a complementary test in Hidradenitis Suppurativa. Dermatol Surg. 2017;43:1065–73.

    Article  CAS  PubMed  Google Scholar 

  31. Friedman SJ, Butler DF. Perilesional linear atrophy and hypopigmentation after intralesional corticosteroid therapy: report of two cases and review of the literature. J Am Acad Dermatol. 1988;19:537–41.

    Article  CAS  PubMed  Google Scholar 

  32. Ovadja ZN, Jacobs W, Zugaj M, et al. Recurrence rates following excision of hidradenitis suppurativa: a systematic review and meta-analysis. Dermatol Surg. 2020;46:E1–7.

    Article  CAS  PubMed  Google Scholar 

  33. Moreno-Artero E, Rodríguez-Garijo N, Tomás-Velázquez A, et al. Pre-surgical mapping of non-melanoma skin cancer by ultrasound. Piel. 2019;34:175–9.

    Article  Google Scholar 

  34. García-Martínez FJ, Alfageme Roldan F. Intervencionismo cutáneo guiado por ecografía. In: Alfageme F, Roustan G, editors. Ecografía en Dermatología y Dermoestética. Madrid: Panamericana; 2017. p. 159–64.

    Google Scholar 

  35. García-Martínez FJ, de Cabo FF. Contrast-enhanced ultrasound with peroxide hydrogen for hidradenitis suppurativa and pilonidal sinus presurgical mapping. J Am Acad Dermatol. 2021;

  36. Kim Y, Park YJ. Three-dimensional endoanal ultrasonographic assessment of an anal fistula with and without H2O2 enhancement. World J Gastroenterol. 2009;15:4810–5.

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations


Corresponding author

Correspondence to Francisco Javier García Martínez .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2022 The Author(s), under exclusive license to Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

García Martínez, F.J. (2022). Ultrasound-Assisted Hidradenitis Suppurativa Procedures. In: Wortsman, X. (eds) Textbook of Dermatologic Ultrasound. Springer, Cham.

Download citation

  • DOI:

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-031-08735-6

  • Online ISBN: 978-3-031-08736-3

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics