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Histomorphometric Analyses of Hidradenitis Suppurativa Tissue Identify the Need for Ultrasound Diagnostics
Location: 28
Mentor: Dr. Irena Pastar
Hidradenitis Suppurativa (HS) is a chronic inflammatory skin disease characterized by painful nodules, abscesses, and advanced stage dermal tunnels. HS is disproportionately prevalent in patients of minority populations including African and Hispanic populations. Proposed reasons for the disproportionate prevalence include delay in diagnosis and frequent misdiagnosis. These factors suggest that patients of minority populations experience a greater disease severity and increased risk of manifesting HS tunnels, known to limit patients’ response to currently approved biologic therapies. A deeper understanding of how diagnosis protocols and techniques contribute to disease severity is critical for preventing the progression of HS severity in patients. Studies point to ultrasound imaging, aiding in defining tunnel morphology and depth. In addition to clinical exam, histopathological analyses of excised tissue provide diagnostic tools of HS tissue abnormalities. We aimed to highlight disease severity utilizing histomorphometric analysis of dermal tunnels. Nine patients (67% female) were included in this study. 44% of patients identified as White, 11% as Asian, 11% as Black, 11% as Hispanic/White, and 22% undisclosed. 51 biopsy specimens from the nine patients containing tunnels were collected, fixed in formalin and processed for paraffin embedding. The tissue was sectioned and analyzed by H&E staining and the depth of the tunnels and extent of tunnel epithelialization was measured using ImageJ. Results show that the average length from the epidermis to the surface of the tunnel is 3.9 mm, the maximum length is 5.23 mm and minimum length is 0.99 mm. Tunnel epithelialization was confirmed by pan-keratine immuno staining. Our findings support the use of ultrasound imaging for the timely diagnoses of HS tunnels, with the ultimate goal are to prevent disease progression and burden in populations affected by HS.
