Hurley Staging for Hidradenitis Suppurativa
Three-stage clinical classification of hidradenitis suppurativa (Hurley 1989). Drives initial therapeutic stratification per BAD 2018 guidelines.
Score interpretation
→ Topical clindamycin 1% BD; lifestyle (smoking cessation, weight reduction). Punch debridement / deroofing for individual lesions. Reassess at 12 weeks.
→ Oral antibiotics: clindamycin + rifampicin 12 weeks (or doxycycline 100 mg BD). If poor response → adalimumab 160 mg loading then 80 mg / 40 mg weekly per NICE TA392. Surgical excision of recurrent lesions.
→ Specialist dermatology + surgery. Adalimumab / secukinumab (NICE TA800); consider plastic-surgery wide local excision with primary closure or grafting for stable disease. Long-term immunosuppression. Pain management, mental-health support.
Interpretation bands for the Hurley HS. Apply clinical judgement and local guidance.
References
Related
Curated clinical cross-links plus same-class fallbacks.
- Suspicious Pigmented Lesion — Melanoma Pathway · NICE NG14 2015 / BAD
- Cellulitis and Erysipelas · NICE NG141 2019 / CREST
- Psoriasis — Severity Assessment and Step-Up Therapy · NICE NG153 2019 / BAD
- Atopic Eczema — Assessment and Step-Up Therapy · NICE NG95 2023
- Urticaria and Angioedema · BSACI / EAACI Guidelines 2022
- Acne Vulgaris — Grading and Treatment · NICE NG198 2021 / BAD
Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.