Contrast-enhanced ultrasound with peroxide hydrogen for hidradenitis suppurativa and pilonidal sinus presurgical mapping

Surgical challenge
Surgery is probably the best treatment for recurrent hidradenitis suppurativa. However, the average recurrence rate after an adjusted excision and primary closure for hidradenitis suppurativa fistulous tracts ranges between 15% and 37%,1 and wide excisions are often mutilating.

Solution
Ultrasonography is the most appropriate tool for diagnosing and staging hidradenitis suppurativa and pilonidal sinus. Ultrasonographically guided delimitation techniques can also be used in the design of pilonidal sinus and hidradenitis suppurativa excision margins.

An inexpensive product, such as hydrogen peroxide, is commonly used by surgeons and radiologists as a contrast in the study of perianal fistulas with endoanal ultrasonography because it facilitates the detection of subclinical sinuses and secondary tracts.2

CITATION  J Am Acad Dermatol. 2023 Apr;88(4):e163-e164.
doi: 10.1016/j.jaad.2020.12.074. Epub 2021 Jan 9