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 view photos of HS.

BACK
FRONT

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

Hurley stage I

Single or a few isolated boils without sinus tracts* or scarring1,2

  • underarm
  • underarm

Hurley stage II

Recurring boils in single or multiple areas with scarring and sinus tracts.1,2

  • underarm
  • underarm
  • underarm

Hurley stage III

Widespread boils with multiple interconnected tracts across the affected area.1,2 This may be associated with an unpleasant smelling discharge.2

  • underarm
  • underarm

Hurley stage I

Single or a few isolated boils without sinus tracts* or scarring1,2

  • underarm
  • underarm

Hurley stage II

Recurring boils in single or multiple areas with scarring and sinus tracts.1,2

  • underarm
  • underarm
  • underarm

Hurley stage III

Widespread boils with multiple interconnected tracts across the affected area.1,2 This may be associated with an unpleasant smelling discharge.2

  • underarm
  • underarm

Hurley stage I

Single or a few isolated boils without sinus tracts* or scarring1,2

  • groin
  • groin
  • groin

Hurley stage II

Recurring boils in single or multiple areas with scarring and sinus tracts.1,2

  • groin
  • groin
  • groin

Hurley stage III

Widespread boils with multiple interconnected tracts across the affected area.1,2 This may be associated with an unpleasant smelling discharge.2

  • groin
  • groin

Hurley stage I

Single or a few isolated boils without sinus tracts* or scarring1,2

  • buttocks
  • buttocks
  • buttocks

Hurley stage II

Recurring boils in single or multiple areas with scarring and sinus tracts.1,2

  • buttocks
  • buttocks
  • buttocks

Hurley stage III

Widespread boils with multiple interconnected tracts across the affected area.1,2 This may be associated with an unpleasant smelling discharge.2

  • buttocks
BACK
FRONT

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

Hurley stage I

Single or a few isolated boils without sinus tracts* or scarring1,2

  • Underarm
  • Underarm

Hurley stage II

Recurring boils in single or multiple areas with scarring and sinus tracts.1,2

  • Underarm
  • Underarm
  • Underarm

Hurley stage III

Widespread boils with multiple interconnected tracts across the affected area.1,2 This may be associated with an unpleasant smelling discharge.2

  • Underarm
  • Underarm

Hurley stage I

Single or a few isolated boils without sinus tracts* or scarring1,2

  • Underarm
  • Underarm

Hurley stage II

Recurring boils in single or multiple areas with scarring and sinus tracts.1,2

  • Underarm
  • Underarm
  • Underarm

Hurley stage III

Widespread boils with multiple interconnected tracts across the affected area.1,2 This may be associated with an unpleasant smelling discharge.2

  • Underarm
  • Underarm

Hurley stage I

Single or a few isolated boils without sinus tracts* or scarring1,2

  • Breast
  • Breast

Hurley stage II

Recurring boils in single or multiple areas with scarring and sinus tracts.1,2

  • Breast
  • Breast
  • Breast

Hurley stage III

Widespread boils with multiple interconnected tracts across the affected area.1,2 This may be associated with an unpleasant smelling discharge.2

  • Breast
  • Breast
  • Breast

Hurley stage I

Single or a few isolated boils without sinus tracts* or scarring1,2

  • Groin
  • Groin
  • Groin

Hurley stage II

Recurring boils in single or multiple areas with scarring and sinus tracts.1,2

  • Groin
  • Groin
  • Groin

Hurley stage III

Widespread boils with multiple interconnected tracts across the affected area.1,2 This may be associated with an unpleasant smelling discharge.2

  • Groin
  • Groin

Hurley stage I

Single or a few isolated boils without sinus tracts* or scarring1,2

  • Buttocks
  • Buttocks
  • Buttocks

Hurley stage II

Recurring boils in single or multiple areas with scarring and sinus tracts.1,2

  • Buttocks

Hurley stage III

Widespread boils with multiple interconnected tracts across the affected area.1,2 This may be associated with an unpleasant smelling discharge.2

  • Buttocks
  • Buttocks
  • Buttocks

 

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

Not all cases of HS are progressive (meaning that the condition can increase in severity over time). However, some cases of HS can continue to reappear and 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 physician. As HS is not a widely known disease, it is recommended that you consult a dermatologist (who specialises in skin health) with any questions you have. Visit our Talking to Your Dermatologist section for information and tips to help guide a discussion with a dermatologist.

*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.7
*Abscess: Collection of pus7
*Perianal: area around the anus7

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 May 2016.
  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 May 2016.