Shedding Light on Hidradenitis Suppurativa Activity: A Pilot Study to Evaluate the Potential of [99mTc]Tc-Anti-TNF-Alpha Scintigraphy

Shedding light on Hidradenitis Suppurativa activity: a pilot study to evaluate the potential of [^99mTc]Tc-anti-TNF-alpha scintigraphy. <b>Background/Objectives</b>: Hidradenitis suppurativa (HS), also known as acne inversa and Verneuil's disease, is a chronic and non-contagious auto-inflammatory disease of pilo-sebaceous units that can lead to severe complications and sequelae. The actual prevalence of HS is unknown due to diagnostic delay and/or misdiagnosis, but it is estimated to affect 0.00033-4.1% of the general population worldwide. Only severe cases are referred for imaging assessment, and the final diagnosis is mostly established on a clinical basis. Here, we present a pilot study aiming to evaluate clinically active inflammatory disease in patients with HS using [^99mTc]Tc-anti-TNF-alpha scintigraphy. <b>Methods</b>: Four patients (2 male, 2 female) had their HS clinical features measured through the HS-PGA and Hurley Score and compared to [^99mTc]Tc-anti-TNF-alpha scintigraphy findings. <b>Results</b>: Scintigraphy with [^99mTc]Tc-anti-TNF-alpha showed abnormal uptake in clinically active lesions of HS and also detected some clinically unknown potential active lesions, later confirmed by clinical reassessment after the imaging. <b>Conclusions</b>: Our results suggest that scintigraphy with [^99mTc]Tc-anti-TNF-alpha may be able to detect increased radiotracer uptake in most clinically identified active lesions in this pilot cohort. While promising, due to the inherent limitations of this pilot study, more studies need to be carried out to arrive at a definitive diagnostic assessment of active inflammatory disease using this method.