Hidradenitis suppurativa (HS) is classified by the Hurley staging system. A patient with multiple interconnected sinus tracts and scarring over both axillae with no areas of normal skin represents:

• A Hurley Stage I
• B Hurley Stage III ✓
• C Hurley Stage II
• D Hurley Stage IV (advanced)

Explanation

Hurley Stage III HS is defined by diffuse involvement of the affected area with multiple interconnected sinus tracts and extensive scarring, with no or few unaffected intervening areas. Stage I is characterised by abscess formation without sinus tracts or scarring. Stage II involves recurrent abscesses with sinus tract formation and cicatrisation but with normal skin in between. HS is a disorder of terminal follicular occlusion in apocrine gland-bearing areas, not primarily an infection of apocrine glands. There is no Hurley Stage IV.

Reference: Neena Khanna Illustrated Synopsis of Dermatology & STD, 6th ed.

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Written and medically reviewed by the StethoPrep medical team.