Photographic Assessment of the Anatomic Localization and Extent of Hidradenitis Suppurativa: A Delphi Study.

BACKGROUND

Hidradenitis suppurativa (HS) is a chronic inflammatory disease with fluctuating activity that requires long-term visual documentation to evaluate disease severity and treatment response. A standardized protocol for photographing HS is critically needed.

OBJECTIVES

To establish a standardized protocol for using photography to clinically document HS.

METHODS

We brought together a panel of international experts and used a modified Delphi process to reach consensus on statements about standardized practices for using photography to document HS in clinical practice and research settings. A 75% agreement level was prespecified as the cutoff for consensus.

RESULTS

Consensus for photographically documenting HS was developed within 6 key areas: patient preparation, background, lighting, size and reference scale, camera considerations, and patient positioning. The revised and optimized protocol includes 34 standardized reference illustrations. However, the proposed recommendations are for ideal scenarios, and their implementation may not always be practical in a clinical setting. Variations in resources may not have been captured.

CONCLUSIONS

The proposed consensus-based protocol provides a standard for consistent photographic documentation of HS. This protocol may help clinicians provide better disease surveillance and patient care, and it may aid in more precise and reliable research and clinical trials for HS.