What Are the Stages of HS?

Christopher Sayed, M.D., associate professor of dermatology professor at the University of North Carolina at Chapel Hill, talks about the symptoms of HS, which includes persistent, painful abscesses, and nodules.

The most common staging system for HS is what's called the Hurley staging system. In Hurley stage 1 disease, that's where mostly there are just abscesses and nodules that come and go, and the skin can generally return to normal as those lesions resolve.

Once you get to Hurley stage 2 disease, that's where you start to see tunnels or sinus tracks that develop – some people refer to them as fistulas. These are areas where there is scar and a pocket, or a tunnel, that exists under the skin that stays there over a longer period of time and becomes recurrently inflamed. If you have just one, or a very limited amount of area involved by those types of lesions, that's considered early stage, too. Once that becomes widespread and interconnected, that's where it becomes Hurley stage 3 disease.

That staging system is mostly designed to help figure out how much patients need potential surgical intervention over time. It's not a great system that changes over time with response to medicines. It helps to understand maybe what's necessary for treatment in the long run for those patients, though.