{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T11:48:58Z","timestamp":1775044138055,"version":"3.50.1"},"reference-count":10,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Multimodal high-resolution ultrasound, including B-mode, Power Doppler, MicroVessel Doppler, spectral Doppler, and strain elastography, was used to assess concomitant dactylitis and hidradenitis suppurativa (HS) in a 46-year-old woman with severe hidradenitis suppurativa (IHS4 = 28), who was diagnosed 1.5 years ago and has been using adalimumab. Axillary ultrasound demonstrated abscess cavities and draining fistulous tracts with marked structural distortion, increased vascular signal on advanced Doppler modalities, and heterogeneous stiffness patterns on elastography, consistent with active deep inflammatory involvement. Simultaneously, evaluation of the third right finger revealed flexor tendon sheath thickening, soft-tissue edema, Doppler-positive inflammatory activity, and altered biomechanical properties compatible with dactylitis. High-resolution ultrasound has been increasingly recognized as a valuable tool for evaluating inflammatory and structural changes in cutaneous diseases, including HS. These multimodal findings illustrate how structural, vascular, and biomechanical ultrasound parameters may provide complementary information for characterizing inflammatory tissue remodeling in HS associated with dactylitis. As this report describes a single patient, these elastographic observations should be considered exploratory and hypothesis-generating rather than evidence of clinical validation.<\/jats:p>","DOI":"10.3390\/diagnostics16071059","type":"journal-article","created":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T10:09:21Z","timestamp":1775038161000},"page":"1059","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Integrated Doppler and Elastography Assessment of Hidradenitis Suppurativa and Dactylitis"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1689-6705","authenticated-orcid":false,"given":"Jos\u00e9 Alexandre","family":"Mendon\u00e7a","sequence":"first","affiliation":[{"name":"Stricto Sensu Postgraduate Program in Health Sciences\/Ultrasonography\/Rheumatology Service, Pontifical Catholic University of Campinas (PUC-Campinas), S\u00e3o Paulo 13060-904, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2492-8474","authenticated-orcid":false,"given":"B\u00e1rbara","family":"Brunca","sequence":"additional","affiliation":[{"name":"Dermatology Service, Pontifical Catholic University of Campinas (PUC-Campinas), S\u00e3o Paulo 13060-904, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ana Paula","family":"Weber","sequence":"additional","affiliation":[{"name":"Dermatology Service, Pontifical Catholic University of Campinas (PUC-Campinas), S\u00e3o Paulo 13060-904, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paula Tavares","family":"Colpas","sequence":"additional","affiliation":[{"name":"Dermatology Service, Pontifical Catholic University of Campinas (PUC-Campinas), S\u00e3o Paulo 13060-904, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,4,1]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1401","DOI":"10.1111\/bjd.15748","article-title":"Development and validation of the International Hidradenitis Suppurativa Severity Score System (IHS4), a novel dynamic scoring system to assess HS severity","volume":"177","author":"Zouboulis","year":"2017","journal-title":"Br. J. Dermatol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"2149","DOI":"10.1002\/jum.16759","article-title":"Correlation Between Ultra-High Frequency Ultrasound (UHFUS) and Histological Features of Typical Lesions in Hidradenitis Suppurativa","volume":"44","author":"Michelucci","year":"2025","journal-title":"J. Ultrasound Med."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"2137","DOI":"10.1111\/jdv.15710","article-title":"Ultrasound as a diagnostic and management tool in hidradenitis suppurativa patients: A multicentre study","volume":"33","author":"Martorell","year":"2019","journal-title":"J. Eur. Acad. Dermatol. Venereol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"670","DOI":"10.1016\/j.abd.2023.10.003","article-title":"Doppler ultrasound protocol for patients with hidradenitis suppurativa","volume":"99","author":"Denofre","year":"2024","journal-title":"An. Bras. Dermatol."},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Giavedoni, P., Roman\u00ed, J., de Cabo, F., Garc\u00eda-Mart\u00ednez, F.J., Quintana-Codina, M., Ro\u00e8-Crespo, E., de Vega, I.F., Soria-Gili, X., Aguayo-Ortiz, R., and Garbayo-Salmons, P. (2025). Advanced Doppler Ultrasound Insights: A Multicenter Prospective Study on Healthy Skin. Diagnostics, 15.","DOI":"10.3390\/diagnostics15050569"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"688","DOI":"10.1111\/bjd.19343","article-title":"Doppler ultrasound-based noninvasive biomarkers in hidradenitis suppurativa: Evaluation of analytical and clinical validity","volume":"184","author":"Grand","year":"2020","journal-title":"Br. J. Dermatol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"E137","DOI":"10.1055\/s-0043-119412","article-title":"Strain Elastography\u2014How To Do It?","volume":"3","author":"Dietrich","year":"2017","journal-title":"Ultrasound Int. Open"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"e652","DOI":"10.1111\/jdv.18116","article-title":"Shear wave elastography as a potential tool for quantitative assessment of sinus tracts fibrosis in hidradenitis suppurativa","volume":"36","author":"Iznardo","year":"2022","journal-title":"J. Eur. Acad. Dermatol. Venereol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1060","DOI":"10.1136\/ard-2023-225278","article-title":"Validation and incorporation of digital entheses into a preliminary Global OMERACT Ultrasound Dactylitis Score (GLOUDAS) in psoriatic arthritis","volume":"83","author":"Naredo","year":"2024","journal-title":"Ann. Rheum. Dis."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"74","DOI":"10.4103\/0378-6323.74999","article-title":"Dactylitis as a first manifestation of arthritis associated with hidradenitis suppurativa","volume":"77","author":"Fioravanti","year":"2011","journal-title":"Indian J. Dermatol. Venereol. Leprol."}],"container-title":["Diagnostics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4418\/16\/7\/1059\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T10:23:26Z","timestamp":1775039006000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4418\/16\/7\/1059"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,1]]},"references-count":10,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2026,4]]}},"alternative-id":["diagnostics16071059"],"URL":"https:\/\/doi.org\/10.3390\/diagnostics16071059","relation":{},"ISSN":["2075-4418"],"issn-type":[{"value":"2075-4418","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,1]]}}}