TY - JOUR
T1 - Real-Time Confocal Imaging for Hidradenitis Suppurativa: Description of Morphological Aspects and Focus on the Role of Follicular Ostia
AU - Cappilli, Simone
AU - Giovanardi, Giulia
AU - Di Stefani, Alessandro
AU - Longo, Caterina
AU - Longo, Carmela
AU - Perino, Franco
AU - Chiricozzi, Andrea
AU - Peris, Ketty
PY - 2021
Y1 - 2021
N2 - 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.
AB - 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.
KW - Comedos
KW - Digital imaging
KW - Follicular units
KW - Hidradenitis suppurativa
KW - Reflectance confocal microscopy
KW - Comedos
KW - Digital imaging
KW - Follicular units
KW - Hidradenitis suppurativa
KW - Reflectance confocal microscopy
UR - http://hdl.handle.net/10807/206071
U2 - 10.1159/000513918
DO - 10.1159/000513918
M3 - Article
SN - 1018-8665
SP - 1-7-7
JO - Dermatology
JF - Dermatology
ER -