📏 Modified Sartorius Score (mSS)

Hidradenitis Suppurativa severity — Sartorius et al., 2009 (HS-LASI)

Purpose
Region-by-region objective severity score for hidradenitis suppurativa based on lesion type, count, distribution and extent within each anatomical area.
Population
All patients with HS. Particularly useful for longitudinal follow-up of individual patients over time.
Formula
Per region: 3 (if involved) + nodules×1 + fistulas×6 + distance score + Hurley III bonus (9 pts)
Important note
No validated severity thresholds. Score change between visits is more meaningful than the absolute value.
⚠️ Clinical Notes & Limitations
  • ⏱ Time-consuming in extensive disease — not ideal for rapid clinical assessment.
  • 📈 Designed for longitudinal follow-up, not cross-sectional diagnosis. The change in score between visits is clinically more meaningful than a single absolute value.
  • ⚠️ No validated mild/moderate/severe thresholds exist for any version of the Sartorius score.
  • 👤 Intra-rater reliability is very good, but inter-rater reliability is poor. Always use the same clinician to score the same patient across visits.
  • 📋 Three versions exist (2003, 2007, 2009) with different formulas. This calculator uses the 2009 modified version (mSS / HS-LASI). Always specify the version when reporting results.
  • 🧠 Purely objective. Does not capture patient-reported outcomes. Consider supplementing with a VAS pain scale and number of boils/flares in the past month.
🗺️ Region Assessment

Tap each region to mark it as involved. For each active region, enter the lesion details below.

📚 References
  1. Sartorius K, Lapins J, Emtestam L, Jemec GBE. Suggestions for uniform outcome variables when reporting treatment effects in hidradenitis suppurativa. Br J Dermatol. 2003;149(1):211–3.
  2. Revuz J. Modifications et mode d'emploi du score de Sartorius pour évaluer la gravité de l'hidradénite suppurée. Ann Dermatol Vénéréol. 2007;134(2):173–4.
  3. Sartorius K, Emtestam L, Jemec GBE, Lapins J. Objective scoring of hidradenitis suppurativa reflecting the role of tobacco smoking and obesity. Br J Dermatol. 2009;161(4):831–9.
  4. Deckers IE, Kimball AB. The Handicap of Hidradenitis Suppurativa. Front Med (Lausanne). 2023;10:1145152.
  5. 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.