HURLEY CLINICAL STAGING SYSTEM | CHARACTERISTICS | RECOMMENDED TREATMENT | ||
---|---|---|---|---|
NONMEDiCAL | PHARMACOLOGIC | SURGICAL | ||
Stage I (mild) | Single or multiple abscesses without sinus tracts and scarring | The following steps should be considered regardless of the severity of HS (grade F, level III):
| First-line treatments:
Second-line treatments:
| Incision and drainage (not encouraged) |
Stage II (moderate) | Recurrent abscesses with sinus tracts and scarring | First-line treatments:
Second-line treatments:
| If multiple medical therapies have failed, refer to a plastic surgeon for excisions | |
Stage III (severe) | Diffuse or multiple interconnected sinus tracts and abscesses across the entire area | Refer to a dermatologist who might initiate the following:
| If multiple medical therapies have failed, refer to a plastic surgeon for excisions |
HS—hidradenitis suppurativa, IL CCS—intralesional corticosteroid.
Data from Alikhan et al,3 Zouboulis et al,21 and Alhusayen et al.22