📋 Refined Hurley Staging

Seven-stage HS classification — Horváth et al., 2017 · Rondags et al., 2019

Purpose
Refined 7-stage classification of HS severity incorporating sinus tract presence, body area extent, inflammation and lesion mobility.
Population
All patients with HS. Designed for daily clinical practice as a quick severity and treatment guide.
Criteria
Based on: sinus tracts · body areas involved · degree of inflammation · lesion type (fixed vs. migratory)
Severity grades
A = Mild · B = Moderate · C = Severe within each Hurley stage. Stage III always severe.
🏥 Classic Hurley Staging — Reference

Static anatomical classification. Use IHS4 to quantify severity within each stage.

Stage I
I
Abscess formation
Single or multiple abscesses. No sinus tracts, no cicatrization.
Stage II
II
Recurrent abscesses
Recurrent abscesses with sinus tract formation and cicatrization. Single or multiple, widely separated lesions.
Stage III
III
Diffuse involvement
Diffuse or near-diffuse involvement, or multiple interconnected sinus tracts and abscesses across the entire area.
🔀 Interactive Staging

Answer each question to determine the refined Hurley stage.

📚 References
  1. Hurley H. Axillary hyperhidrosis, apocrine bromhidrosis, hidradenitis suppurativa, and familial benign pemphigus: surgical approach. In: Roenigh RK, Roenigh HH, eds. Dermatologic Surgery. New York: Marcel Dekker; 1989. p. 729–39.
  2. Horváth B, Janse IC, Blok J, et al. Hurley staging refined: a proposal by the Dutch Hidradenitis Suppurativa Expert Group. Acta Derm Venereol. 2017;97(3):412–3.
  3. Rondags A, van Straalen KR, van Hasselt JR, et al. Correlation of the refined Hurley classification for hidradenitis suppurativa with patient-reported quality of life and objective disease severity assessment. Br J Dermatol. 2019;180(5):1214–20.
  4. Zouboulis CC, et al. S2k guidelines for the treatment of hidradenitis suppurativa/acne inversa. J Dtsch Dermatol Ges. 2024.
Clinical decision support only. This tool is intended to assist clinical assessment and does not replace professional judgment. Always interpret results in the context of the individual patient.