Hidradenitis suppurativa

Hurley classification[4]Hurley H. Axillary hyperhidrosis, apocrine bromhidrosis, hidradenitis suppurativa, and familial benign pemphigus. In: Roenigk RH, Roenigk HH Jr, eds. Dermatologic surgery: principles and practice. New York, NY: Marcel Dekker; 1989:729-739.[5]Kim WB, Sibbald RG, Hu H, et al. Clinical features and patient outcomes of hidradenitis suppurativa: a cross-sectional retrospective study. J Cutan Med Surg. 2016;20:52-57. http://journals.sagepub.com/doi/full/10.1177/1203475415602840 http://www.ncbi.nlm.nih.gov/pubmed/26318545?tool=bestpractice.com [6]Martorell A, García-Martínez FJ, Jiménez-Gallo D, et al. An update on hidradenitis suppurativa (part I): epidemiology, clinical aspects, and definition of disease severity. Actas Dermosifiliogr. 2015;106:703-715. http://www.actasdermo.org/en/an-update-on-hidradenitis-suppurativa/articulo/S1578219015002437 http://www.ncbi.nlm.nih.gov/pubmed/26254550?tool=bestpractice.com

The severity of HS can be classified based on the configuration of inflammatory lesions and scars. This method is widely used to stratify disease severity at initial presentation. It is useful to guide treatment choice.[4]Hurley H. Axillary hyperhidrosis, apocrine bromhidrosis, hidradenitis suppurativa, and familial benign pemphigus. In: Roenigk RH, Roenigk HH Jr, eds. Dermatologic surgery: principles and practice. New York, NY: Marcel Dekker; 1989:729-739.[5]Kim WB, Sibbald RG, Hu H, et al. Clinical features and patient outcomes of hidradenitis suppurativa: a cross-sectional retrospective study. J Cutan Med Surg. 2016;20:52-57. http://journals.sagepub.com/doi/full/10.1177/1203475415602840 http://www.ncbi.nlm.nih.gov/pubmed/26318545?tool=bestpractice.com [6]Martorell A, García-Martínez FJ, Jiménez-Gallo D, et al. An update on hidradenitis suppurativa (part I): epidemiology, clinical aspects, and definition of disease severity. Actas Dermosifiliogr. 2015;106:703-715. http://www.actasdermo.org/en/an-update-on-hidradenitis-suppurativa/articulo/S1578219015002437 http://www.ncbi.nlm.nih.gov/pubmed/26254550?tool=bestpractice.com

• Hurley stage I (mild): presence of abscesses and inflammatory nodules but without scarring. [Figure caption and citation for the preceding image starts]: Hidradenitis suppurativa stage I: discrete inflamed nodules and papules with intervening normal skin and lack of scarringFrom R.A. Lee, MD, PhD [Citation ends].

• Hurley stage II (moderate): presence of abscesses and inflammatory nodules with scarring. However, inflammatory lesions and scars are separated by areas of intervening normal skin. [Figure caption and citation for the preceding image starts]: Hidradenitis suppurativa stage II: inflamed nodules and scars with areas of intervening normal skinFrom R.A. Lee, MD, PhD [Citation ends].

• Hurley stage III (severe): extensive interconnected scars with or without active inflamed lesions. [Figure caption and citation for the preceding image starts]: Hidradenitis suppurativa stage III: interconnected scars, cysts, comedones, and inflamed nodulesFrom R.A. Lee, MD, PhD [Citation ends].