Correlation of the refined Hurley classification for hidradenitis suppurativa with patient-reported quality of life and objective disease severity assessment

A. Rondags, K. R. van Straalen, J. R. van Hasselt, I. C. Janse, C. B. Ardon, A. R. J. V. Vossen, E. P. Prens, H. H. van der Zee, B. Horvath*

*Corresponding author for this work

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Abstract

Background Hidradenitis suppurativa (HS) is a chronic, debilitating, heterogeneous disease requiring different treatment approaches. Recently, we refined the classic Hurley classification into a seven-stage classification in order to guide these treatment choices. This new classification subdivides Hurley stage I and II into three substages, namely mild (A), moderate (B) and severe (C) HS disease. Hurley stage III is not subcategorized and is always severe. Objectives To investigate the correlation between the given severity grades of Hurley I and Hurley II in the refined Hurley classification, and the patient-reported quality of life and physician-assessed objective severity score. Materials and methods In this cross-sectional study, patients with HS participating in the observational cohorts of two Dutch tertiary referral centres were included before June 2017. The patient-reported Dermatology Life Quality Index (DLQI) and physician-assessed International HS Severity Score System (IHS4) scores were compared between the refined Hurley stages. Results In total, 433 patients were analysed. DLQI and IHS4 scores increased within Hurley stage I and II from A through C. There was a significant positive correlation of DLQI and IHS4 with increasing refined Hurley substages [refined Hurley stage I (A, B and C) to DLQI: r(s) = 0 center dot 259, P <0 center dot 001 and refined Hurley stage II (A, B and C) to DLQI: r(s) = 0 center dot 185, P = 0 center dot 010; refined Hurley stage I (A, B and C) to IHS4: r(s) = 0 center dot 603, P <0 center dot 001 and refined Hurley stage II (A, B and C) to IHS4: r(s) = 0 center dot 532, P <0 center dot 001]. Conclusions The refined Hurley classification accurately correlates with HS severity assessed by both patients and clinicians. Therefore, the refined Hurley classification is a useful tool for the quick assessment of severity in HS.

Original languageEnglish
Pages (from-to)1214-1220
Number of pages7
JournalBritish Journal of Dermatology
Volume180
Issue number5
DOIs
Publication statusPublished - May-2019

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