International consensus statement on the use of ultrasound in hidradenitis suppurativa

Background: So far, the evidence on the use of ultrasound (US) in hidradenitis suppurativa (HS) demonstrates the utility of US in the diagnosis, scoring and assessment of HS; however, to date, there is no international consensus statement on the use of US in HS, and several published guidelines do not include this topic. Objectives: To create an international consensus statement on using US in HS that can cover and validate relevant aspects. Methods: A three-round Delphi study with a panel of international experts representing four continents and working with US in HS in their daily practice. The inclusion criteria of the experts and the set of questions in the survey were defined by a steering committee. A consensus of recommendation was defined when the percentage of agreement (sum of strongly agree and agree) was ε 70%. In between 50% and 69% of agreement, a suggestion was considered. Lower than 50% meant no consensus. Results: Twenty-four international experts from 14 countries participated in the study. A high percentage of consensus (96.4%) was achieved for important aspects of the use of US in HS, including the ultrasonographic indications, technical considerations, training, diagnostic criteria, staging systems, monitoring, support of US-guided procedures and planning of surgery, and the need for US in research and clinical trials. Conclusions: An international group of experts created a consensus statement with validated recommendations on the use of US in HS. Despite the challenges of the implementation of ultrasound in HS, this task force highly recommends the use of US in HS.