Background: Hidradenitis suppurativa (HS) is a chronic, recurrent, inflammatory skin disease involving the follicular unit. Growing evidence suggests a crucial role of hyperkeratosis, infundibular plugging and perifolliculitis in its pathogenesis. Objectives: To characterize the microscopic morphology of open comedos using in vivo reflectance confocal microscopy (RCM) and define alterations occurring in HS normal-Appearing perilesional skin compared to healthy skin of a control group, discussing therefore microscopic differences. Materials and Methods: Twenty patients (11 males, 9 females; aged 19-51 years) affected by HS were recruited. RCM was performed on open comedos of axillary/inguinal regions and on normal-Appearing skin areas distant at least 1.5 cm from HS lesions. Ten healthy individuals (6 males, 4 females) were included as control group. Results: RCM aspects of 78 open comedos were explored, observing circular/ovoidal structures disclosing a hyperrefractive amorphous material (72/78, 92.3%) within the infundibular cavity surrounded with a bright (51/78, 65.4%) and regular (52/78, 66.2%) border. Follicular ostia of HS perilesional skin (n = 541) compared to follicular ostia of a control group (n = 321) were characterized by a larger infundibular diameter (183.4 vs. 85.8 μm) and diverged in terms of material collected inside infundibula (44.5 vs. 21%) and keratinization of the border (47.6 vs. 25.5%). Conclusion: In vivo characterization of open comedos and the recognition of microscopic subclinical alterations of HS normal-Appearing skin, compared to healthy skin, could add further insights into the definition of biological events leading to HS manifestations, including the dysregulated process of keratinization.

Real-Time Confocal Imaging for Hidradenitis Suppurativa: Description of Morphological Aspects and Focus on the Role of Follicular Ostia / Cappilli, S.; Giovanardi, G.; Di Stefani, A.; Longo, C.; Perino, F.; Chiricozzi, A.; Peris, K.. - In: DERMATOLOGY. - ISSN 1018-8665. - 237:5(2021), pp. 705-711. [10.1159/000513918]

Real-Time Confocal Imaging for Hidradenitis Suppurativa: Description of Morphological Aspects and Focus on the Role of Follicular Ostia

Longo C.;
2021

Abstract

Background: Hidradenitis suppurativa (HS) is a chronic, recurrent, inflammatory skin disease involving the follicular unit. Growing evidence suggests a crucial role of hyperkeratosis, infundibular plugging and perifolliculitis in its pathogenesis. Objectives: To characterize the microscopic morphology of open comedos using in vivo reflectance confocal microscopy (RCM) and define alterations occurring in HS normal-Appearing perilesional skin compared to healthy skin of a control group, discussing therefore microscopic differences. Materials and Methods: Twenty patients (11 males, 9 females; aged 19-51 years) affected by HS were recruited. RCM was performed on open comedos of axillary/inguinal regions and on normal-Appearing skin areas distant at least 1.5 cm from HS lesions. Ten healthy individuals (6 males, 4 females) were included as control group. Results: RCM aspects of 78 open comedos were explored, observing circular/ovoidal structures disclosing a hyperrefractive amorphous material (72/78, 92.3%) within the infundibular cavity surrounded with a bright (51/78, 65.4%) and regular (52/78, 66.2%) border. Follicular ostia of HS perilesional skin (n = 541) compared to follicular ostia of a control group (n = 321) were characterized by a larger infundibular diameter (183.4 vs. 85.8 μm) and diverged in terms of material collected inside infundibula (44.5 vs. 21%) and keratinization of the border (47.6 vs. 25.5%). Conclusion: In vivo characterization of open comedos and the recognition of microscopic subclinical alterations of HS normal-Appearing skin, compared to healthy skin, could add further insights into the definition of biological events leading to HS manifestations, including the dysregulated process of keratinization.
2021
237
5
705
711
Real-Time Confocal Imaging for Hidradenitis Suppurativa: Description of Morphological Aspects and Focus on the Role of Follicular Ostia / Cappilli, S.; Giovanardi, G.; Di Stefani, A.; Longo, C.; Perino, F.; Chiricozzi, A.; Peris, K.. - In: DERMATOLOGY. - ISSN 1018-8665. - 237:5(2021), pp. 705-711. [10.1159/000513918]
Cappilli, S.; Giovanardi, G.; Di Stefani, A.; Longo, C.; Perino, F.; Chiricozzi, A.; Peris, K.
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11380/1236608
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