Stages A case of<unk>  File:Micrograph of<unk> .Micrograph of<unk> : Sinus tracts (A), arrow, active inflammation, and rupture (B), asterisks of the follicular epithelium with “floating” hair fragments (B), arrow. Subsequently, a secondary inflammatory response is induced with influx of numerous neutrophils (C), arrows and granulomatous foreign body reaction with giant cells (C), asterisks.<unk>  presents itself in three stages. Due to the large spectrum of clinical severity and the severe impact on quality of life, a reliable method for evaluating<unk>  severity is needed. Hurley's staging system Hurley's staging system was the first classification system proposed, and is still in use for the classification of patients with skin diseases (i.e., psoriasis,<unk> , acne). Hurley separated patients into three groups based largely on the presence and extent of cicatrization and sinuses. It has been used as a basis for clinical trials in the past and is a useful basis to approach therapy for patients. These three stages are based on Hurley's staging system, which is simple and relies on the subjective extent of the diseased tissue the patient has. Hurley's three stages of<unk>  are: Stage Characteristics I Solitary or multiple isolated abscess formation without scarring or sinus tracts (A few minor sites with rare inflammation; may be mistaken for acne.) II Recurrent abscesses, single or multiple widely separated lesions, with sinus tract formation (Frequent inflammation restricts movement and may require minor surgery such as incision and drainage.) III Diffuse or broad involvement across a regional area with multiple interconnected sinus tracts and abscesses (Inflammation of sites to the size of golf balls, or sometimes baseballs; scarring develops, including subcutaneous tracts of infection – see fistula. Obviously, patients at this stage may be unable to function.) Sartorius staging system The Sartorius staging system is more sophisticated than Hurley's. Sartorius et al. suggested that the Hurley system is not sophisticated enough to assess treatment effects in clinical trials during research. This classification allows for better dynamic monitoring of the disease severity in individual patients. The elements of this staging system are: * Anatomic regions involved (axilla, groin gluteal, or other region or inframammary region left or right) * Number and types of lesions involved (abscesses, nodules, fistulas or sinuses, scars, points for lesions of all regions involved) * The distance between lesions, in particular the longest distance between two relevant lesions (i.e., nodules and fistulas in each region or size if only one lesion present) * The presence of normal skin in between lesions (i.e., if all lesions are clearly separated by normal skin) Points are accumulated in each of the above categories, and added to give both a regional and total score. In addition, the authors recommend adding a visual analog scale for pain or using the dermatology life quality index (DLQI, or the 'skindex') when assessing<unk> .
Hidradenitis suppurativa
Acne
Folliculitis decalvans
Pilonidal disease
Streptococcal intertrigo
Acne conglobata
Helicobacter cellulitis
Keratolysis exfoliativa