Table 1.
Therapeutic approach of HS.
| Hurley Staging (HS Severity) |
Clinical Features | Recommended Treatments | Surgery |
|---|---|---|---|
| Stage I (mild) | Single or multiple abscesses without sinus tracts and scarring | Patient education: maintaining hygiene standards, cessation of smoking, losing weight * Topical clindamycin, antisepticsIntralesional corticosteroids |
Incision and drainage Deroofing Laser |
| Stage II (moderate) | Recurrent abscesses with sinus tracts and scarring | Systemic antibiotics: tetracycline, clindamycin + rifampicin, rifampicin + moxifloxacin + metronidazole, ertapenem Immune modulators: prednisolone, retinoids, dapsone, cyclosporine |
Local intervention Deroofing Laser |
| Stage III (severe) | Diffuse or multiple interconnected sinus tracts and abscesses across the entire area | Biologics: adalimumab, bimekizumab (phase III)/secukinumab (phase III), others (Table 2) |
Extensive radical surgical excision |