Hidradenitis Suppurativa Symptoms

One of the first steps in understanding Hidradenitis Suppurativa (HS) is educating yourself about the signs and symptoms of the condition. Here, you can learn about the variations of HS and see pictures of the skin symptoms of HS.

 

HS is often mistaken for an infection, therefore delay in correct diagnosis is not uncommon.1 Dermatologists typically assess the signs and symptoms of HS on a scale – these categories are developed from a clinical measure of severity called the Hurley scale.1,2

Some cases of HS are progressive (meaning that the condition increases in severity over time), although not all cases grow more severe over time. As a result, diagnosing and properly managing HS as early as possible is critical.2-5 The first step is to speak to your GP who may refer you to a dermatologist for an accurate diagnosis.

It’s important for those living with HS to have an open and honest dialogue with your doctor. As HS is not a widely known disease, it is recommended that you consult a dermatologist (a doctor who specialises in skin health) with any questions you have.

Click on the diagram to see mild, moderate and severe cases of affected areas for male.

Click on the diagram to see mild, moderate and severe cases of affected areas for female.

HS is measured in ‘Hurley stages’ – 1 is mild, 2 moderate and 3 is severe.

Mild – (Hurley stage 1)

  • Underarm
  • Underarm

Moderate – (Hurley stage 2)

  • underarm
  • underarm

Severe – (Hurley stage 3)

  • underarm
  • underarm

HS is measured in ‘Hurley stages’ – 1 is mild, 2 moderate and 3 is severe.

Mild – (Hurley stage 1)

  • Underarm
  • Underarm

Moderate – (Hurley stage 2)

  • underarm
  • underarm

Severe – (Hurley stage 3)

  • underarm
  • underarm

HS is measured in ‘Hurley stages’ – 1 is mild, 2 moderate and 3 is severe.

Mild – (Hurley stage 1)

  • groin
  • groin
  • groin

Moderate – (Hurley stage 2)

  • groin
  • groin
  • groin

Severe – (Hurley stage 3)

  • groin
  • groin

HS is measured in ‘Hurley stages’ – 1 is mild, 2 moderate and 3 is severe.

Mild – (Hurley stage 1)

  • buttocks
  • buttocks
  • buttocks

Moderate – (Hurley stage 2)

  • buttocks
  • buttocks
  • buttocks

Severe – (Hurley stage 3)

  • buttocks

HS is measured in ‘Hurley stages’ – 1 is mild, 2 moderate and 3 is severe.

Mild – (Hurley stage 1)

  • Underarm
  • Underarm

Moderate – (Hurley stage 2)

  • Underarm

Severe – (Hurley stage 3)

  • Underarm

HS is measured in ‘Hurley stages’ – 1 is mild, 2 moderate and 3 is severe.

Mild – (Hurley stage 1)

  • Underarm
  • Underarm

Moderate – (Hurley stage 2)

  • Underarm

Severe – (Hurley stage 3)

  • Underarm

HS is measured in ‘Hurley stages’ – 1 is mild, 2 moderate and 3 is severe.

Mild – (Hurley stage 1)

  • Breast
  • Breast

Moderate – (Hurley stage 2)

  • Breast
  • Breast
  • Breast

Severe – (Hurley stage 3)

  • Breast
  • Breast
  • Breast

HS is measured in ‘Hurley stages’ – 1 is mild, 2 moderate and 3 is severe.

Mild – (Hurley stage 1)

  • Groin
  • Groin
  • Groin

Moderate – (Hurley stage 2)

  • Groin
  • Groin
  • Groin

Severe – (Hurley stage 3)

  • Groin
  • Groin

HS is measured in ‘Hurley stages’ – 1 is mild, 2 moderate and 3 is severe.

Mild – (Hurley stage 1)

  • Buttocks
  • Buttocks
  • Buttocks

Moderate – (Hurley stage 2)

  • Buttocks

Severe – (Hurley stage 3)

  • Buttocks
  • Buttocks
  • Buttocks

HS is measured in ‘Hurley stages’ - 1 is mild, 2 moderate and 3 is severe.

Hurley grade I lesions:

Single or a few isolated boils without sinus tracts or scarring.1,2 Painful bumps and abscesses in the armpits, groin, under the breasts, buttocks or inner thigh. These tender bumps generally start as firm, pea-sized nodules. Since they’re often red, the bumps are often mistaken for acne, an ingrown hair or sexual disease such as herpes.

Hurley grade II lesions:

Recurring boils in multiple areas with scarring and sinus tracts.1,2 Scarring can occur with HS as a result of long-term or repeat occurrences in a single location.

Hurley grade III lesions:

Widespread boils (can be as large as golf balls) with multiple interconnected sinus tracts, which may lead to severe scarring and the release of unpleasant-smelling pus.1,2

 

*Sinus tract: Narrow channels that form under the skin and break out on the surface6

*Fistulas: A fistula occurs when channels, called sinus tracts, tunnel into other parts of the body, such as the bowel or bladder.6
*Abscess: Collection of pus6
*Perianal: area around the anus6

REFERENCES:

  1. Jemec GB. Clinical practice. Hidradenitis suppurativa. N Engl J Med 2012;366:158–164.
  2. Revuz J. Hidradenitis suppurativa. J Eur Acad Dermatol Venereol 2009;23:985–998.
  3. Mayo Clinic. Hidradenitis Suppurativa. Available at: http://www.mayoclinic.org/diseases-conditions/hidradenitis-suppurativa/symptoms-causes/dxc-20200019. Accessed April 2021.
  4. Collier F, Smith R, Morton C. Diagnosis and management of hidradenitis suppurativa. BMJ 2013;346:f2121.
  5. Zouboulis CC, Tsatsou F. Disorders of the apocrine sweat glands. In: Goldsmith LA, Katz SI, Gilchrest BA, Paller AS, Leffell DJ, Wolff K. Fitzpatrick’s Dermatology in General Medicine. 8th ed. New York, Chicago: McGraw Hill; 2012. p947–959.
  6. https://patient.info/health/hidradenitis-suppurativa-leaflet. Accessed April 2021.

 

AU-HUM-210055 August 2022.