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 patients living with 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 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 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 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 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 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 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 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 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 multiple areas with scarring and sinus tracts1,2

  • 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

 

Because HS is often mistaken for an infection, a long delay in 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.2,3,4,5 The first step for HS patients is to speak to your dermatologist to help ensure an accurate diagnosis.

It’s important for those living with HS to have an open and honest dialogue with your physician. Because HS is not a widely known disease, it is recommended that you consult a dermatologist (who specializes 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.

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.com/health/hidradenitis-suppurativa/DS00818. Accessed August 2013.
  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.