Table 9. Comparison of scoring systems for hidradenitis suppurativa.
| Scoring system | Score vs. category | Variables | Involved area count | Subjective items | Validation | Other characteristics |
|---|---|---|---|---|---|---|
| Hurley staging (1989) | Category | Inflammatory lesions, tunnel, scars, distance | - | - | - | Designed to aid selecting the treatment modality |
| Refined Hurley classification (2016) | Category | Number of areas/lesions, BSA, presence of sinus tract | + | - | Comparison with IHS4 and DLQI | - |
| Sartorius score (2003), Revuz-modified Sartorius score (2007) | Score | Number of areas/lesions (coefficient adjusted), distance, Hurley III | + | - | Retrospective assessment in 34 HS patients | - |
| Modified Sartorius score (2009) | Score | Number of lesions (adjusted), distance, Hurley III | + | - | Comparison with Hurley staging, DLQI | Calculated region by region |
| HSSI (2010) | Score | Number of areas/lesions, BSA, drainage, VAS of pain | + | Pain | Phase II infliximab RCT | No need to distinguish elementary lesions |
| HS-PGA (2012) | Category | Number of abscess & draining fistula, inflammatory/non-inflammatory nodules | - | - | Phase II adalimumab RCT | - |
| HiSCR (2012) | Category | Responsiveness (at least a 50% reduction from baseline, with no increase of numbers of abscesses or draining fistulae) | - | - | Phase III adalimumab RCT | Useful in research (twofold nature) |
| AISI (2015) | Score | Number of areas/lesions (coefficient adjusted), illness-VAS | + | Illness | Comparison with Hurley staing, modified Sartorius score, DLQI | - |
| IHS4 (2017) | Score | Number of lesions (coefficient adjusted) | - | - | A two-round Delphi voting / comparison with Hurley, PGA, mSS | - |
| IHS4-55 (2022) | Category | Responders (55% reduction)/non responders | - | - | Phase III adalimumab RCT | Useful in research (twofold nature) |
| SAHS (2018) | Score | Number of areas/ILOFs, fistulas, new/flared boils in past 4 weeks, NRS of pain | + | Pain | Comparison with Hurley, mSS | Captured recurrent nature of HS |
| HASI-R (2020) | Score | Inflammatory color change, duration, open skin surface, tunnels, BSA | + | - | Cohort of 20 physicians (HISTORIC) | Inspired by PASI |
| HIDRAscore (2020) | Score | Inflammatory nodules, abscesses, draining fistulas, HIDRAdisk, subumbilical lesions | Sub-/supra-umbilical | Quality of life | Subject satisfaction questionnaire (SSQ) | Weight subumbilical lesions |
| HS-IGA (2022) | Category | Number of lesions | Sub-/supra-umbilical | - | Phase III adalimumab RCT | No need to distinguish elementary lesions |
BSA: body surface area, HS: hidradenitis suppurativa, IHS4: international hidradenitis suppurativa severity scoring system, DLQI: dermatologic life quality index, PGA: physician’s global assessment, mSS: modified Sartorius score, HSSI: hidradenitis suppurativa severity index, HS-PGA: hidradenitis suppurativa physician’s global assessment scale, VAS: visual analogue scale, RCT: randomized controlled trial, HiSCR: hidradenitis suppurativa clinical response, AISI: acne inversa severity index, SAHS: severity assessment of hidradenitis suppurativa, HASI-R: hidradenitis suppurativa area and severity index revised, HS-IGA: hidradenitis suppurativa investigator global assessment, HISTORIC: HIdradenitis SuppuraTiva cORre outcome set International Collaboration, PASI: psoriasis area and severity index, IGA: investigator’s global assessment.