Hidradenitis suppurativa (trądzik odwrócony)
Diagnostyka i diagnoza

Hidradenitis suppurativa (HS) to przewlekła, zapalna dermatoza charakteryzująca się bolesnymi, głęboko osadzonymi guzkami, ropniami, przetokami i bliznami włóknistymi, lokalizującymi się typowo w okolicach pach, pachwin, narządów płciowych, pośladków oraz pod piersiami. Diagnoza opiera się na trzech kluczowych kryteriach: obecności charakterystycznych zmian zapalnych, typowej lokalizacji oraz nawrotowym przebiegu (≥2 nawroty w ciągu 6 miesięcy lub utrzymywanie się zmian ≥3 miesiące). Średni czas od pojawienia się objawów do prawidłowej diagnozy wynosi 7-10 lat, co znacząco utrudnia leczenie i pogarsza jakość życia pacjentów. Diagnostyka opiera się na szczegółowym wywiadzie i badaniu fizykalnym, z wykorzystaniem narzędzi takich jak klasyfikacja Hurleya (stadia I-III) oraz ocena odpowiedzi na leczenie za pomocą HiSCR (≥50% redukcja liczby ropni i guzków zapalnych w 12. tygodniu). Dodatkowo, ultrasonografia wysokiej częstotliwości może ujawnić głębokie zmiany i przetoki niewidoczne klinicznie, a badania mikrobiologiczne i laboratoryjne wspomagają różnicowanie i ocenę stanu zapalnego.

  1. Diagnostyka Hidradenitis Suppurativa (trądzik odwrócony)
    1. Kryteria diagnostyczne
    2. Wywiad i badanie fizykalne
    3. Badania dodatkowe
    4. Ocena stopnia ciężkości
    5. Rozpoznanie różnicowe
  2. Wyzwania diagnostyczne w HS
    1. Opóźnienie diagnostyczne
    2. Znaczenie wczesnej diagnozy
    3. Specjalistyczne podejście do diagnozy
  3. Nowe podejścia diagnostyczne w HS
    1. Narzędzia wspierające diagnostykę
    2. Różnice w diagnostyce HS w populacjach specjalnych
    3. Rola edukacji w poprawie diagnostyki
  4. Podsumowanie diagnostyki HS
    1. Kolejne rozdziały

Diagnostyka Hidradenitis Suppurativa (trądzik odwrócony)

Hidradenitis suppurativa (HS), znany również jako trądzik odwrócony, jest przewlekłą, zapalną chorobą skóry, charakteryzującą się bolesnymi zmianami takimi jak głęboko osadzone guzki, ropnie, przetoki skórne i blizny włókniste. Diagnoza HS często bywa opóźniona, co negatywnie wpływa na doświadczenia pacjentów i może prowadzić do progresji choroby. Średni czas od pojawienia się pierwszych objawów do prawidłowej diagnozy wynosi nawet 7-10 lat, co znacząco utrudnia efektywne leczenie i pogarsza jakość życia pacjentów.123

Kryteria diagnostyczne

Diagnoza HS opiera się głównie na obrazie klinicznym i nie wymaga specjalistycznych badań laboratoryjnych potwierdzających chorobę. Aby zdiagnozować HS, należy stwierdzić obecność trzech podstawowych kryteriów:123

  • Charakterystyczne zmiany skórne – obecność typowych zmian zapalnych, takich jak bolesne, głęboko osadzone guzki (tzw. „ślepe wrzody”), ropnie, przetoki, blizny mostkowe oraz podwójne zaskórniki (pseudozaskórniki)12
  • Typowa lokalizacja zmian – występowanie zmian w co najmniej jednym z charakterystycznych miejsc: pachy, pachwiny, okolice narządów płciowych, pośladki, okolice okołoodbytnicze, pod piersiami lub między piersiami. Rzadziej zmiany mogą występować na szyi, twarzy, skórze głowy, plecach, klatce piersiowej lub nogach12
  • Nawrotowy i przewlekły charakter – nawracające zmiany w tych samych lub różnych lokalizacjach, przy czym dwa lub więcej nawrotów w ciągu 6 miesięcy lub utrzymywanie się zmian przez co najmniej 3 miesiące jest typowe dla HS12

Wszystkie trzy kryteria muszą być spełnione, aby postawić pewną diagnozę HS.1 Dodatkowe czynniki, które mogą wspierać diagnozę, to:1

  • Obecność blizn, które mogą wskazywać na zaawansowany proces chorobowy
  • Występowanie HS w rodzinie (do 40% pacjentów ma krewnego z HS)
  • Symetryczne występowanie zmian (jeśli jedna strona ciała jest dotknięta, często odpowiadający obszar po drugiej stronie również)

Wywiad i badanie fizykalne

Diagnoza HS opiera się przede wszystkim na dokładnym wywiadzie medycznym i badaniu fizykalnym.12 Dermatolog podczas badania:12

  • Zbiera szczegółowy wywiad dotyczący objawów, ich początku, lokalizacji, częstości nawrotów oraz wpływu na codzienne funkcjonowanie
  • Bada miejsca występowania guzków, drenażu, bólu lub innych objawów
  • Ocenia wszystkie podejrzane zmiany skórne, zwracając uwagę na charakterystyczne cechy odróżniające HS od trądziku, czyraków i innych chorób skóry
  • Może zadawać kluczowe pytania diagnostyczne, takie jak: „Czy w ciągu ostatnich 12 miesięcy miał/a Pan/i wielokrotnie duże, bolesne guzki i wrzody w pachach lub pachwinach?”, „Czy miał/a Pan/i nawroty wrzodów w ciągu ostatnich sześciu miesięcy?”, „Czy regularnie występują u Pana/i duże rany, bolesne guzki lub wrzody, które goją się pozostawiając blizny?”1

Pełne badanie skóry jest niezbędne do oceny rozległości i nasilenia HS oraz określenia wpływu leczenia.1 Badanie fizykalne samo w sobie może jednak nie doszacować ciężkości i zaangażowania choroby, dlatego w niektórych przypadkach stosuje się dodatkowe metody diagnostyczne.2

Badania dodatkowe

Chociaż nie istnieje specyficzny test laboratoryjny do diagnozowania HS, w niektórych przypadkach mogą być wykonywane dodatkowe badania:123

  • Badanie mikrobiologiczne – jeśli obecna jest wydzielina lub drenaż, lekarz może pobrać próbkę do badania mikrobiologicznego, aby wykluczyć zakażenie. Wyniki posiewów są często negatywne lub wykazują mieszaną florę bakteryjną, co może być wskazówką diagnostyczną12
  • Badania obrazowe – ultrasonografia może ujawnić zmiany w głębokiej części mieszka włosowego oraz wykryć przetoki i tunele podskórne, które nie są widoczne gołym okiem12
  • Badania laboratoryjne – pacjenci z ostrymi zmianami mogą mieć podwyższone OB, niekiedy podwyższoną liczbę białych krwinek, niski poziom żelaza w surowicy oraz nieprawidłowości w elektroforezie białek surowicy1
  • Biopsja skóry – rzadko wykonywana, ale może być pomocna w wykluczeniu raka płaskonabłonkowego w przypadkach niepewnych diagnostycznie12

W przypadku HS ważne jest również ocenianie chorób współistniejących, które często towarzyszą tej jednostce chorobowej, takich jak: choroby zapalne jelit, zapalenie stawów, zespół metaboliczny, otyłość, zaburzenia psychiczne czy zespół policystycznych jajników.12

Ocena stopnia ciężkości

Po postawieniu diagnozy HS istotne jest określenie stopnia ciężkości choroby, co wpływa na wybór odpowiedniego leczenia. Najczęściej stosowanym systemem oceny ciężkości HS jest klasyfikacja Hurleya, która dzieli chorobę na trzy stadia:122

  • Stadium I – pojedynczy ropień lub wielokrotne izolowane ropnie bez blizn lub przetok
  • Stadium II – nawracające ropnie z pojedynczymi lub wieloma bliznami i/lub przetokami, z wyraźnie oddzielonymi zmianami
  • Stadium III – wielokrotne zmiany z rozległym bliznowaceniem i tworzeniem przetok obejmujące cały region, wszystkie zmiany są ze sobą połączone

Innym narzędziem oceny odpowiedzi na leczenie jest HiSCR (Hidradenitis Suppurativa Clinical Response), które definiuje się jako co najmniej 50% redukcję całkowitej liczby ropni i guzków zapalnych bez zwiększenia liczby ropni i bez zwiększenia liczby drenaży przetok w stosunku do wartości wyjściowej w 12. tygodniu.123

Rozpoznanie różnicowe

HS może być mylone z wieloma innymi chorobami skóry, co przyczynia się do opóźnień w diagnostyce. Najczęstsze stany, z którymi należy różnicować HS, to:123

  • Trądzik – zmiany trądzikowe zazwyczaj nie są tak bolesne jak w HS i występują głównie na twarzy, klatce piersiowej i plecach
  • Czyrak (furunculus) – pojedyncze, ropne zmiany, które nie nawracają tak regularnie jak w HS
  • Zapalenie mieszków włosowych (folliculitis) – zazwyczaj mniej bolesne i płytsze niż zmiany w HS
  • Choroby przenoszone drogą płciową – mogą dawać podobne objawy, ale badania laboratoryjne pomogą w ich wykluczeniu
  • Torbiele skórne – zazwyczaj nie są tak bolesne i zapalne jak zmiany w HS
  • Wrastające włosy – mniej nasilone i ograniczone do pojedynczych mieszków włosowych

Wczesne i dokładne zróżnicowanie HS od innych schorzeń skórnych jest kluczowe dla rozpoczęcia odpowiedniego leczenia i zapobiegania postępowi choroby.12

Wyzwania diagnostyczne w HS

Opóźnienie diagnostyczne

Opóźnienie w diagnozie HS stanowi poważny problem kliniczny i wpływa na progresję choroby oraz jakość życia pacjentów. Średni czas od wystąpienia objawów do postawienia właściwej diagnozy wynosi 7-10 lat u dorosłych i 1-2 lata u dzieci.12 Przyczyny tego opóźnienia są wieloczynnikowe i obejmują:12

  • Niewłaściwe rozpoznanie przez lekarzy (średnio 3-5 błędnych diagnoz przed postawieniem właściwej)
  • Brak świadomości i wiedzy o HS wśród personelu medycznego (tylko 23,7% lekarzy rodzinnych czuje się pewnie w diagnostyce HS)
  • Zróżnicowany obraz kliniczny HS, który może być podobny do innych chorób skóry
  • Wstyd pacjentów związany z lokalizacją zmian i opóźnienie w szukaniu pomocy medycznej
  • Brak specyficznych testów diagnostycznych dla HS

Badania wykazują, że pacjenci z HS często są badani przez co najmniej pięciu różnych lekarzy zanim otrzymają prawidłową diagnozę.12 Szczególnie trudne może być rozpoznanie HS we wczesnym stadium, gdy zmiany przypominają trądzik lub inne powszechne choroby skóry.1

Znaczenie wczesnej diagnozy

Wczesna diagnoza i leczenie HS mają kluczowe znaczenie z kilku powodów:123

  • Zapobieganie progresji do bardziej zaawansowanych stadiów choroby
  • Redukcja ryzyka powstawania nieodwracalnych zmian, takich jak blizny i przetoki
  • Poprawa skuteczności leczenia – wczesne interwencje są zazwyczaj bardziej efektywne
  • Zapobieganie powikłaniom, takim jak zakażenia wtórne
  • Poprawa jakości życia pacjentów poprzez zmniejszenie bólu i dyskomfortu
  • Redukcja kosztów opieki zdrowotnej związanych z zaawansowanym HS

Gdy pacjenci osiągają stadium tworzenia przetok, bliznowacenia lub wymagają interwencji chirurgicznej, powrót do lepszego stanu wyjściowego jest znacznie trudniejszy.1 Dlatego wczesne rozpoczęcie leczenia jest kluczowe dla zwiększenia ogólnej jakości życia pacjentów przed wystąpieniem nieodwracalnych procedur i bliznowacenia z przetokami.2

Specjalistyczne podejście do diagnozy

Dermatolodzy są często lekarzami, którzy diagnozują pacjentów z HS, ponieważ posiadają specjalistyczne szkolenie pozwalające na odróżnienie HS od innych chorób skóry.12 Jednakże, ze względu na złożoność HS i potencjalne choroby współistniejące, może być konieczne wielodyscyplinarne podejście do diagnostyki i leczenia.1

Lekarze podstawowej opieki zdrowotnej mogą zarówno diagnozować, jak i leczyć wczesną postać choroby, ale w przypadku podejrzenia HS powinni rozważyć skierowanie pacjenta do dermatologa, szczególnie gdy:12

  • Pacjenci nie uzyskują kontroli objawów przy zastosowaniu standardowych terapii
  • Choroba jest ciężka (Stadium Hurleya 3) już w momencie diagnozy lub zajmuje wiele obszarów
  • Choroba ma znaczący wpływ na jakość życia pacjenta
  • Diagnoza jest niepewna i wymagana jest dalsza ocena

Koordynowana opieka między różnymi specjalistami, w tym dermatologami, chirurgami, gastroenterologami i psychiatrami, może być niezbędna dla skutecznego zarządzania HS, zwłaszcza w przypadkach zaawansowanych.12

Nowe podejścia diagnostyczne w HS

Narzędzia wspierające diagnostykę

W celu poprawy wczesnego wykrywania HS opracowywane są nowe narzędzia diagnostyczne, w tym:12

  • Modele uczenia maszynowego – badania pokazują, że modele uczenia maszynowego mogą pomóc w przewidywaniu diagnozy HS i odróżnianiu jej od innych chorób skóry, osiągając dokładność diagnostyczną na poziomie 65-73% i pole pod krzywą ROC 81-82%
  • Kwestionariusze przesiewowe – proste narzędzia oparte na trzech kluczowych pytaniach diagnostycznych mogą zwiększyć wykrywalność HS w podstawowej opiece zdrowotnej
  • Zaawansowane techniki obrazowania – ultrasonografia wysokiej częstotliwości może poprawić wykrywanie przetok i tuneli podskórnych we wczesnych stadiach choroby

Implementacja tych narzędzi może pomóc systemom opieki zdrowotnej w identyfikacji pacjentów z niezdiagnozowanym HS do dalszej oceny i badań.2

Różnice w diagnostyce HS w populacjach specjalnych

Diagnostyka HS może różnić się w zależności od grupy pacjentów:123

  • Populacja pediatryczna – badania wykazują, że ponad 40% pacjentów pediatrycznych z HS nie spełnia wszystkich głównych kryteriów diagnostycznych w momencie diagnozy, szczególnie kryterium dotyczącego nawrotów (dwie lub więcej zmian w ciągu 6 miesięcy)
  • Pacjenci z ciemniejszą karnacją – HS nieproporcjonalnie dotyka pacjentów kolorowych i wiąże się z większym nasileniem choroby. Znajomość obrazu klinicznego HS na ciemniejszych odcieniach skóry może pomóc w dokładniejszej identyfikacji HS
  • Różnice związane z wiekiem i płcią – analizy wskazują, że starszy wiek wiąże się z krótszym czasem do diagnozy po wystąpieniu objawów, podczas gdy palacze i pacjenci z chorobami współistniejącymi lub rodzinną historią HS są diagnozowani wolniej

Te różnice podkreślają potrzebę zindywidualizowanego podejścia do diagnostyki HS, uwzględniającego specyficzne cechy różnych grup pacjentów.12

Rola edukacji w poprawie diagnostyki

Poprawa świadomości i wiedzy o HS wśród pracowników służby zdrowia i ogółu społeczeństwa jest kluczowa dla przyspieszenia diagnozy:123

  • Edukacja lekarzy podstawowej opieki zdrowotnej na temat objawów i kryteriów diagnostycznych HS
  • Zwiększanie świadomości wśród pacjentów, aby zachęcić ich do wcześniejszego poszukiwania pomocy medycznej
  • Szkolenia dla lekarzy na temat różnic w prezentacji HS w różnych grupach etnicznych i wieku
  • Rozwój jasnych ścieżek skierowań do dermatologów w przypadku podejrzenia HS
  • Informowanie o dostępnych opcjach leczenia, aby pacjenci wiedzieli, że HS można skutecznie leczyć

Lekarze powinni również nauczyć się podstaw stosowania leków biologicznych, aby mogli wyjaśnić pacjentom, jak działają te terapie przed skierowaniem do dermatologa.1 Budowanie zaufania z pacjentami może być największym wyzwaniem w skutecznym zarządzaniu HS, szczególnie u tych, którzy odwiedzili wielu lekarzy i uzyskali niewielką satysfakcję z tych spotkań.1

Podsumowanie diagnostyki HS

Diagnostyka Hidradenitis suppurativa (trądzik odwrócony) pozostaje wyzwaniem klinicznym ze względu na zróżnicowany obraz choroby, brak specyficznych testów laboratoryjnych i podobieństwo do innych chorób skóry.12 Diagnoza opiera się na trzech kluczowych kryteriach: obecności charakterystycznych zmian zapalnych, typowej lokalizacji zmian oraz nawrotowym charakterze choroby.12

Wczesne rozpoznanie HS ma kluczowe znaczenie dla skutecznego leczenia i zapobiegania progresji do zaawansowanych stadiów choroby z nieodwracalnymi zmianami.12 Dermatolodzy są często najlepiej przygotowani do diagnozy HS dzięki specjalistycznemu szkoleniu pozwalającemu na odróżnienie HS od innych chorób skóry.12

Klasyfikacja ciężkości HS według skali Hurleya pomaga w doborze odpowiedniego leczenia, a nowe narzędzia, takie jak modele uczenia maszynowego, mogą wspierać wczesną identyfikację pacjentów z HS.12 Multidyscyplinarne podejście do diagnostyki i leczenia, uwzględniające choroby współistniejące i indywidualne potrzeby pacjenta, jest niezbędne dla skutecznego zarządzania tą złożoną chorobą.12

Edukacja zarówno lekarzy, jak i pacjentów odgrywa kluczową rolę w zmniejszeniu opóźnień diagnostycznych i poprawie wyników leczenia HS.12 Z odpowiednią diagnozą i indywidualnym planem leczenia pacjenci z HS mogą skutecznie zarządzać objawami i poprawić jakość życia, pomimo przewlekłego charakteru choroby.12

Kolejne rozdziały

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  1. 10.04.2026
  2. www.leksykon.com.pl

Materiały źródłowe

  • #1 Hidradenitis Suppurativa – StatPearls – NCBI Bookshelf
    https://www.ncbi.nlm.nih.gov/books/NBK534867/
    Hidradenitis suppurativa is a chronic inflammatory skin condition characterized by painful lesions such as deep-seated nodules, abscesses, skin tunnels, and fibrotic scars. […] The diagnosis of hidradenitis suppurativa is clinically based but often challenging and delayed, exacerbating the patient experience. […] Laboratory and imaging tests help characterize the lesions and rule out other conditions. […] Hidradenitis suppurativa diagnosis is often delayed by an average of 7 years due to its resemblance to other conditions. Clinical diagnosis involves recognizing characteristic morphological features (nodules, tunnels, and scars), location (intertriginous areas), and chronicity. […] A diagnosis of hidradenitis suppurativa should prompt evaluation for possible cooccurrence of these conditions.
  • #1 Hidradenitis Suppurativa (HS) Clinical Diagnosis Criteria
    https://www.hsdiseasesource.com/hs-diagnosis-criteria
    Hidradenitis suppurativa (HS) may present in various phenotypes, making diagnosis challenging. Early diagnosis may help improve HS prognosis and prevent extensive and irreversible subdermal damage and scarring. […] The diagnosis of HS is a clinical one using 3 key criteria. No confirmatory laboratory tests exist. […] HS lesions typically present in at least 1 of these locations: axilla, groin, genitals, buttocks, or under the breasts. Other areas may include the neck or abdomen. […] Lesions tend to recur in the affected regions characteristic of HS. Sometimes lesions may recur in the same anatomical location of the body, occur in a different location, or both. […] Two or more recurrences of symptoms over a period of 6 months may be indicative of HS and often referred to as flares or flareups.
  • #1 What Are the Diagnostic Criteria for HS? | Consultant360
    https://www.consultant360.com/exclusives/etiology-and-diagnosis-hidradenitis-suppurativa
    The first part in this 3-part series gives an overview of hidradenitis suppurativa and discuss the disease’s etiology and diagnosis. […] Hidradenitis suppurativa (HS) is a challenging disease for both patients and practitioners given its debilitating nature, its comorbidities, and the complex nature of effective treatment options. […] HS is a clinical diagnosis that can be a challenge. Three diagnostic criteria must be present for definitive diagnosis: The presence of typical lesions of deep-seated painful nodules (known as blind boils without a purulent point) in early lesions and abscesses, sinuses, bridged scars, and tombstone open comedones (pseudocomedones) in secondary lesions. Lesions occurring in at least 1 typical body location such as the axillae, groin, perineal and perianal region, buttocks, and inframammary and intermammary folds. Chronic nature of disease, relapses, and recurrences.
  • #1 Diagnosing Hidradenitis Suppurativa | HS Awareness | HCP
    https://www.hs-awareness.com/identifying-and-diagnosing-hs
    An early diagnosis of hidradenitis suppurativa (HS) can help mitigate disease burdens. HS can be challenging to diagnose as the clinical characteristics may be difficult to identify or mistaken for other conditions. But the consequences of a delayed HS diagnosis can be damaging and may even be permanent. Recognizing the characteristic lesions of HS and how they present across different skin tones can help get patients the care they need to help inhibit further disease progression. […] There are 3 essential diagnostic criteria that can help distinguish HS from other skin conditions. […] One or more painful, inflammatory, deep-seated nodules, abscesses, or comedones. […] Lesions are most common on flexural sites, like the axillae, inframammary, groin, perineal and perianal regions. They are less common on ears, face, scalp, back, chest, or legs.
  • #1 Diagnosing Hidradenitis Suppurativa | HS Awareness | HCP
    https://www.hs-awareness.com/identifying-and-diagnosing-hs
    Recurrence at least twice within 6 months and/or persistence of at least 3 months. […] Knowing the common presentations, common differential diagnoses, and stage of disease can help you identify HS more quickly and make referrals to HS-treating dermatology providers sooner. […] Hidradenitis suppurativa disproportionately affects patients of color and is associated with increased disease severity. Knowing the clinical presentations of HS on darker skin tones may help you accurately identify HS.
  • #1
    https://www.healthshare.com.au/questions/43824-how-is-hidradenitis-suppurativa-diagnosed/
    Hidradenitis Suppurativa (HS) is a clinical diagnosis. At the moment there is no blood test (or diagnostic biomarker) to diagnose the condition. […] diagnosis is based upon the „modified Dessau criteria” which are: […] all 3 criteria must be present for a diagnosis of HS.
  • #1 Hidradenitis Suppurativa (HS) Clinical Diagnosis Criteria
    https://www.hsdiseasesource.com/hs-diagnosis-criteria
    Scarring, which may indicate the disease has already progressed to more severe stages ideally, HS is identified in earlier stages to initiate treatment and hopefully reduce scarring. […] Family history of HS or similar symptoms up to 40% of patients with HS know an affected family member. […] Ultrasound imaging can reveal tracts and tunneling occurring beneath the skin prior to comparable damage appearing on the skins surface.
  • #1 Hidradenitis suppurativa: Diagnosis and treatment
    https://www.aad.org/public/diseases/a-z/hidradenitis-suppurativa-treatment
    A dermatologist is often the doctor who diagnoses a patient with hidradenitis suppurativa. […] Getting an accurate diagnosis and an individualized treatment plan can help prevent this condition from worsening. […] Hidradenitis suppurativa can look like other skin conditions, including acne, boils, or herpes. Dermatologists have the training needed to spot the differences between these conditions. This unique training allows them to diagnose hidradenitis suppurativa quickly. […] If your dermatologist suspects that you may have hidradenitis suppurativa, heres what typically happens. Your dermatologist will: […] Ask where you have lumps, drainage, pain, or other signs. Hidradenitis suppurativa tends to occur in certain areas, like the underarms, groin, buttocks, or under the breasts. […] Examine some (or all) the bumps and sores. Hidradenitis suppurativa has certain features, which to the trained eye distinguish it from acne, boils, and other conditions.
  • #1 diagnosis and treatment of hidradenitis suppurativa | UAMS Department of Family and Preventive Medicine
    https://medicine.uams.edu/familymedicine/tag/diagnosis-and-treatment-of-hidradenitis-suppurativa/
    Hidradenitis suppurativa (HS) is a skin disorder that starts with blocked hair follicles, leading to painful nodules, abscesses and scarring. […] Three key diagnostic questions every provider must ask the patient: 1. In the last 12 months, did you repeatedly have big, painful nodules and boils in the armpits or groin? 2. Have you had outbreaks of boils in the last six months? 3. Do you repeatedly have outbreaks of big sores, painful nodules or boils that heal with scars in any of these locations? […] If the answer is yes, there is a 90 percent chance of HS. […] Theres no reason healthcare providers should be missing this if they ask these questions, said Dr. Shi. […] HS can show up anywhere on the body behind the ears, outer arms or legs not just the skin folds and areas with sweat glands.
  • #1 Improving the Differential Diagnosis of Hidradenitis Suppurativa – Dermatology Advisor
    https://www.dermatologyadvisor.com/cch/hidradenitis-suppurativa-differential-diagnosis-severity-scores/
    Hidradenitis suppurativa (HS) is a chronic, painfully debilitating skin condition. […] Despite its severe impact on quality of life, HS is plagued by a delay in accurate diagnosis, estimated globally at more than 7 years. […] In general, HS is diagnosed by dermatologists; however, patients often consult several physicians for years before receiving a correct diagnosis. […] The diagnosis of HS is clinical. A full-body skin examination is required to assess the extent and severity of HS and determine the treatments impact. […] A definitive diagnosis requires all 3 of the following criteria to be present: Typical deep-seated painful nodules, often described as blind boils, must be present. […] Clinical examination alone, however, may underestimate the severity and disease involvement of HS.
  • #1 Hidradenitis suppurativa – Diagnosis and treatment – Mayo Clinic
    https://www.mayoclinic.org/diseases-conditions/hidradenitis-suppurativa/diagnosis-treatment/drc-20352311
    Hidradenitis suppurativa can be mistaken for pimples or acne. For many people, it takes years to receive a correct diagnosis. […] Your health care provider will base a diagnosis on your signs and symptoms, skin appearance, and medical history. You might be referred to a health care provider who specializes in skin conditions, also known as a dermatologist. Hidradenitis suppurativa can be difficult to diagnose and requires specialized care. […] No laboratory test is available to diagnose hidradenitis suppurativa. But if pus or drainage is present, your health care provider might take a sample for lab testing.
  • #1 Hidradenitis suppurativa: Diagnosis and treatment
    https://www.aad.org/public/diseases/a-z/hidradenitis-suppurativa-treatment
    Talk with you about what they see on your skin. During this talk, your dermatologist will ask you about your symptoms, when the bumps and sores appeared, and other specifics. This information helps your dermatologist give you an accurate diagnosis. […] If you have a sore thats leaking fluid, your dermatologist may swab a bit of the fluid so that it can be tested. This test can tell your dermatologist whether you have an infection. […] If you have hidradenitis suppurativa, your dermatologist will create a treatment plan tailored to your needs.
  • #1 Hidradenitis Suppurativa Workup: Laboratory Studies, Imaging Studies, Other Tests
    https://emedicine.medscape.com/article/1073117-workup
    The following laboratory tests may be helpful in the evaluation of hidradenitis suppurativa (HS): […] Patients with acute lesions may have an elevated ESR, elevated white blood cell (WBC) count (occasionally), a low serum iron level, and serum protein abnormalities on electrophoresis. […] Ultrasonography (US) of the hair follicles and dermis in HS patients may reveal abnormalities in the deep part of the follicle. […] Bacteriologic analysis should include bacteriologic sampling and cultivation. […] The inflammatory character of type III epithelium, as opposed to that of types I and II, is marked by the presence of CK7 and CK19 and the absence of Dsg1. […] Clinical staging of HS has diagnostic value. […] A study by Matusiak et al showed that the soluble interleukin (IL)-2 receptor serum level in patients with HS can be used as valuable marker for disease staging.
  • #1 Hidradenitis Suppurativa – StatPearls – NCBI Bookshelf
    https://www.ncbi.nlm.nih.gov/books/NBK534867/
    Hidradenitis suppurativa is a clinical diagnosis. No biological or pathological diagnostic tests are required to confirm the condition. However, a biopsy may help rule out squamous cell carcinoma if the diagnosis is uncertain. […] Guidelines recommend additional investigations to assess comorbid conditions in patients with hidradenitis suppurativa.
  • #1 How is Hidradenitis Suppurativa Diagnosed?Share to Facebookprint pageBookmark for latercaret iconFollow us on facebookFollow us on instagramFollow us on facebookFollow us on linkedincaret icon
    https://hsdisease.com/diagnosis
    Tools have been developed for assessing HS. […] Certain conditions and diseases often exist along with HS. Screening for them allows your doctor and care team to provide treatments for your overall health. People with HS should be screened for: Smoking – increases the risk of HS and worsens HS symptoms, Diabetes/metabolic syndrome/obesity – increase risk of cardiovascular-related death. Metabolic syndrome includes large waist size, abnormal triglyceride or cholesterol levels, high blood pressure, and high blood sugar, Depression/anxiety – affect quality of life, Inflammatory arthritis – higher risk of spondyloarthritis, an inflammatory condition that leads to arthritis in the spine and pelvic joints, Inflammatory bowel disease (IBD) – higher risk for Crohn’s disease, a form of IBD, Polycystic ovarian syndrome (POCS) – higher risk of POCS, a hormone disorder marked by high levels of androgen (male hormone) in women, irregular menstrual periods, and cysts on the ovaries, Follicular occlusion tetrad – 4 inflammatory skin diseases that begin with blocked hair follicles: HS, acne conglobata (severe, scarring acne), pilonidal sinus (a tunnel at the cleft between the buttocks), and scalp cellulitis (infection of skin and underlying tissues), Squamous cell carcinoma (SCC) – higher risk for skin cancer.
  • #1 Overview and Diagnosis of Hidradenitis Suppurativa (HS)
    https://www.hcplive.com/view/overview-and-diagnosis-of-hidradenitis-suppurativa-hs
    Everyone presents differently, but nothing replaces a thorough history and physical to diagnose HS. There is no specific diagnostic test available to us at this time to diagnose HS. So its really just getting to know your patients, developing a rapport with them, and doing a thorough physical exam to find certain areas that are consistent with HS. […] And as far as staging HS, typically speaking, we use whats called a Hurley staging. And Hurley staging is divided into stage I, stage II, and stage III. So stage I is a single abscess or multiple isolated abscesses without scar or sinus tract formation. Stage II is recurrent abscesses with either single or multiple scars and/or sinus tract, with widely separated lesions. And then stage III is multiple lesions with extensive scarring and sinus tract formation involving an entire region that is all interconnected.
  • #1 Hidradenitis Suppurativa: Practice Essentials, Pathophysiology, Etiology
    https://emedicine.medscape.com/article/1073117-overview
    The Hurley clinical staging of HS from 1989 is still relevant today; it has diagnostic value but is not suitable for monitoring the efficacy of interventions in clinical trials. […] The HS clinical response (HiSCR), defined as at least a 50% reduction in total abscess and inflammatory nodule count with no increase in abscess count and no increase in draining fistula count relative to baseline at week 12, is the most appropriate clinical end point for assessing treatment effectiveness.
  • #1 Hidradenitis suppurativa (HS)
    https://www.nhs.uk/conditions/hidradenitis-suppurativa/
    There’s no definitive test to help diagnose hidradenitis suppurativa. […] A GP will examine the affected areas of skin, and they may take a swab of an infected area. This can be helpful in making a diagnosis because the condition is not usually associated with the presence of bacteria that cause skin infections. […] Hidradenitis suppurativa could be mistaken for acne or ingrown hairs.
  • #1 Improving the Differential Diagnosis of Hidradenitis Suppurativa – Dermatology Advisor
    https://www.dermatologyadvisor.com/cch/hidradenitis-suppurativa-differential-diagnosis-severity-scores/
    Laboratory investigations have their place in diagnostic evaluations. […] Imaging can play an important role in diagnostic evaluations. […] Patient-reported outcome measures have also been used in diagnostic evaluations. […] Overall, it is important not to rule out a diagnosis of HS too quickly. […] The differential diagnosis of HS can be challenging and complex due to overlapping clinical presentations. […] Once a diagnosis of HS has been made, it is essential to classify the disease severity to tailor treatment. […] Currently, the Hurley scoring system is the most commonly used HS classification in clinical and research settings. […] The differential diagnosis of HS is clinical in approach, requiring specific criteria to be met and ruling out diseases that can mimic the condition. […] Accurately staging HS according to severity is vital to tailoring treatments to meet patients specific needs.
  • #1 Diagnosis & Treatment Obstacles: Hidradenitis Suppurativa | CCID
    https://www.dovepress.com/obstacles-to-early-diagnosis-and-treatment-of-hidradenitis-suppurativa-peer-reviewed-fulltext-article-CCID
    Hidradenitis suppurativa (HS) is a chronic inflammatory skin condition that can progress to significant tunnels and scars that affect quality of life, especially if diagnosis and treatment are delayed. Average delay after initial presentation of HS symptoms can range from 3 to 10 years in adults and 1 to 2 years in children. […] The diagnosis of hidradenitis suppurativa is made clinically based on history and presentation of recurrent typical lesions (inflammatory nodules, abscesses, comedones, scarring, and/or tunnels/sinus tracts) predominantly in the intertriginous (ie, axillae, inframammary, groin, buttocks, etc.) areas. […] Across eleven studies, the diagnosis of HS after initial presentation of symptoms ranged from 3 to 10 years with most studies finding a delay of 6 to 10 years.
  • #1 Clinical Challenge: Diagnosing Hidradenitis Suppurativa | MedPage Today
    https://www.medpagetoday.com/clinical-challenges/aad-inflammatory-skin-condition/94011
    Clinicians and patients alike could make a strong case that diagnosis is the biggest challenge for hidradenitis suppurativa (HS); or more specifically, making the correct diagnosis and making it early. […] A recent multinational survey of patients with HS captured the diagnostic confusion and missteps, as well as patients’ frustration, resulting from inaccurate assessments of the disease. Almost two-thirds of the 1,300 patients said they had been evaluated by a physician at least five times before the correct diagnosis was made. The time to an accurate diagnosis averaged 10 years. […] Another recent report showed that misdiagnosis by non-dermatologists represents one of the biggest barriers to accurate and early diagnosis of HS. […] For a clinician familiar with HS, certain signs and symptoms point toward an HS diagnosis: localized pain, swelling, and tenderness of the affected area, as well as warmth to the touch in the affected area.
  • #1 5 Ways You Can Advocate for a Hidradenitis Suppurativa Diagnosis | SELF
    https://www.self.com/story/hidradenitis-suppurativa-diagnosis-advocacy
    Hidradenitis suppurativa (HS) is a complicated condition thats easily confused for other skin issues, like acne or boils, so it can be tough to get an accurate diagnosis the first time you see a doctor about your symptoms, according to the American Academy of Dermatology (AAD). […] In fact, reports show that it can take some people anywhere from 7 to 12 years to get a hidradenitis suppurativa diagnosis after they first start showing signs of the disease, according to a 2015 paper published in Mayo Clinic Proceedings. […] Patients often end up going to the ER or urgent care seeking acute treatment rather than seeking care with an established provider, Kari Martin, M.D., a board-certified dermatologist at University of Missouri Health Care, tells SELF. […] So, you may be misdiagnosed with something like an infection if the doctor youre seeing isnt as familiar with skin conditions as a board-certified dermatologist, who is specifically trained to parse out the subtle nuances in thousands of skin-related health problems, Dr. Martin says.
  • #1 Overview and Diagnosis of Hidradenitis Suppurativa (HS)
    https://www.hcplive.com/view/overview-and-diagnosis-of-hidradenitis-suppurativa-hs
    Why is early treatment important? It is imperative because once these patients have had sinus tract formation, scarring, or surgical intervention, it is so hard to get them to a better baseline. So its really important to begin earlier rather than later so it can increase their overall quality of life prior to having some of those irreversible procedures and scarring with sinus tracts.
  • #1 Hidradenitis Suppurativa (HS) | HS Awareness | HCP
    https://www.hs-awareness.com/about-hs
    HS is widely under-recognized. This can cause diagnostic delays that can facilitate disease progression and long-lasting negative effects on a patient’s quality of life. Knowing fact from fiction about HS can help get patients the accurate diagnosis and treatment they promptly need. […] Given the numerous comorbidities associated with HS, management coordinated between a multidisciplinary care team should be based on the individual.
  • #1 Hidradenitis suppurativa diagnosis and management in primary care: not just recurrent boils | British Journal of General Practice
    https://bjgp.org/content/73/726/43
    Hidradenitis suppurativa (HS) is characterised by inflamed skin lesions and scars that occur in apocrine-gland-bearing areas including axillae, inframammary folds, and groin, with a chronic course including flares. […] HS significantly impacts general health and quality of life. […] Practitioners in primary care can both diagnose and treat early disease. […] Three main elements need to be considered in a diagnosis of HS: skin changes, locations of lesions, and duration. […] There is no specific investigation to diagnose HS. […] Treatments for HS can be started in primary care. […] Monitoring for comorbidities should be carried out and annual screening is recommended for cardiovascular disease, obesity, tobacco and alcohol use, psychological disorders, inflammatory bowel disease, and inflammatory arthropathies.
  • #1 Exploring Strategies for Timely Diagnosis, Comprehensive Care in Hidradenitis Suppurativa
    https://www.ajmc.com/view/exploring-strategies-for-timely-diagnosis-comprehensive-care-in-hidradenitis-suppurativa
    Researchers reviewed clinical features of hidradenitis suppurativa and provided strategies to promote earlier identification, differentiation from common mimickers, and timely referrals for multidisciplinary management. […] Hidradenitis suppurativa (HS) is a chronic, progressive inflammatory disease of the skin that is frequently underdiagnosed and/or misdiagnosed, in part due to its heterogeneity in presentation and low disease recognition. […] Because of poor recognition of HS within the medical community, the average time between onset of symptoms to diagnosis is approximately 10 years. […] Timely disease recognition and management are essential to controlling symptoms, mitigating disease progression, and improving quality of life for patients with HS, the researchers concluded. Comprehensive care strategies coordinated among medical and surgical disciplines are necessary to improve the overall health of patients with HS.
  • #1 Hidradenitis Suppurativa Diagnosis May Be Predicted and Supported By Machine Learning Model
    https://www.dermatologytimes.com/view/hidradenitis-suppurativa-diagnosis-may-be-predicted-and-supported-by-machine-learning-model
    Researchers have developed a clinical decision support model using machine learning to assist health care providers in predicting diagnoses of hidradenitis suppurativa. […] Utilizing machine learning, researchers developed a clinical decision support model that can aid providers in predicting hidradenitis suppurativa (HS) diagnoses and distinguishing it from other skin conditions that mimic the condition. […] According to a study published in Frontiers in Medical Technology, the model could aid in faster and more accurate recognition of HS, potentially reducing diagnostic delays and associated costs to health care systems. […] Diagnosis relies on clinical criteria, and early recognition is crucial for better management. […] Misdiagnosis and underdiagnosis lead to prolonged suffering and increased health care costs.
  • #1 Diagnostic Criteria for Hidradenitis Suppurativa May Overlook Pediatric Patients
    https://www.ajmc.com/view/diagnostic-criteria-for-hidradenitis-suppurativa-may-overlook-pediatric-patients
    More than a third (42.8%) of pediatric patients with hidradenitis suppurativa did not meet all major diagnostic criteria at the time of diagnosis, particularly due to failure to fulfill the recurrence interval criterion (2 or more lesions within 6 months). […] Consensus-derived diagnostic criteria for HS exist to guide accurate clinical diagnosis, which has shown applicability for adult patients, noted researchers. But these criteria have not been evaluated in pediatric patients, despite most patients reporting onset of HS during adolescence. […] Documentation from the diagnostic visit indicated that major diagnostic criteria were fulfilled in 170 (57.2%) patients and 127 (42.8%) patients did not meet all 3 major HS diagnostic criteria. Of those who did not fulfill HS diagnostic criteria, 122 (96.1%) did not meet the recurrence interval criterion (2 or more lesions within 6 months), followed by 4 patients who did not have a typical lesion and 3 who did not have a typical affected location. […] They concluded that future prospective studies are warranted to determine if revisions to the HS diagnostic criteria are needed to facilitate timely HS diagnosis in a pediatric population.
  • #1 Diagnosis of HS
    https://www.hcplive.com/view/diagnosis-of-hs
    HS [hidradenitis suppurativa] is diagnosed by a clinical diagnosis, so patients will be evaluated by a physician, a PA [physician assistant], or a nurse practitioner, and on evaluation you will notice nodules, abscess, tombstone comedones these are pairs of comedones adjacent to each other and you can have hypertrophic or fibrous scarring. Its a clinical diagnosis. When these patients present with 2 or more recurrent lesions within a 6-month span, thats when you start thinking HS. […] So, many times HS is diagnosed, or I should say theres a delay in diagnosis, and the delay can range somewhere from 7 to 10 years. Now, the question is, why is there such a delay in diagnosis? Part of the problem is these patients are given wrong diagnoses as having plain abscesses, cellulitis, or folliculitis. Often, these patients, on average, have seen 5 medical providers before the correct diagnosis is made. Also playing a role is that 75% of the time, these patients think that this disease or these symptoms theyre having will go away on their own, and that may delay them coming in to be evaluated. Now, how can we improve on the delay of the diagnosis for these individuals? Education is key; educating our colleagues and patients about the signs and symptoms of HS. I feel in the past 2 years there has been a little bit more buzz about HS, and I have been seeing more patients come into my office knowing or thinking that they have this diagnosis because theyve already seen some information on the internet or theyve heard some information from friends and family. The buzz is starting, but we must continue that momentum.
  • #1 diagnosis and treatment of hidradenitis suppurativa | UAMS Department of Family and Preventive Medicine
    https://medicine.uams.edu/familymedicine/tag/diagnosis-and-treatment-of-hidradenitis-suppurativa/
    Dr. Shi recommended a pyramid of treatment. […] Regardless of disease stage, providers should refer the patient to a dermatologist for advanced therapy, while collaboratively managing the patient. […] Dr. Shi said providers should learn the basics of biologics so they can explain how it works before they refer to a dermatologist. The patient must be on at least 90 days of an oral antibiotic before most insurance will allow biologics. […] Ask the three questions to have a high confidence of diagnosing HS. […] Refer to dermatology once diagnosed.
  • #1 Clinical Challenge: Diagnosing Hidradenitis Suppurativa | MedPage Today
    https://www.medpagetoday.com/clinical-challenges/aad-inflammatory-skin-condition/94011
    Adding patient and lesion characteristics to the diagnostic workup can also help guide the diagnosis toward or away from HS. […] A classic distinguishing lesion of HS is two comedones close together and overlying a larger nodule or tract. […] As the disease progresses, signs of more advanced disease, likely requiring surgery, begin to emerge, including nodules and abscesses with underlying tunneling, and scarring. […] Arriving at an accurate diagnosis, and providing reassurance that HS can be treated, can provide the cornerstone for building trust with patients, particularly those who have seen multiple clinicians and obtained little satisfaction from the encounters. […] Building that trust can be the biggest challenge to successful management of HS, said Vij.
  • #1 Hidradenitis Suppurativa (Acne Inversa): Symptoms & Treatments
    https://my.clevelandclinic.org/health/diseases/17716-hidradenitis-suppurativa
    Hidradenitis suppurativa (HS) is a condition that causes painful, recurring boils in areas of your body with sweat glands. There isn’t a cure, but treatment can help manage symptoms and prevent new boils and scarring. […] A dermatologist has special training that helps them recognize the signs of hidradenitis suppurativa. […] A review of your health history and a physical exam is typically all that’s necessary. […] Hidradenitis suppurativa treatment depends on the severity of your symptoms. […] Other medications that help people with hidradenitis suppurativa include: Adalimumab, a biologic therapy that quiets your body’s immune system response. This can ease inflammation. […] If you have severe symptoms or growths that don’t respond to other therapies, you may need a procedure. […] Hidradenitis suppurativa (HS) is a painful condition that causes recurrent painful draining boils and can lead to scarring. If you have painful boils that last for weeks and keep coming back in the other areas mentioned above, please see a healthcare provider.
  • #2 Hidradenitis Suppurativa: Overview, Patient Burden, and Challenges to Diagnosis
    https://www.dermatologytimes.com/view/hidradenitis-suppurativa-overview-patient-burden-and-challenges-to-diagnosis
    Diagnosis of HS is dependent on clinical evaluation rather than lab confirmation and can be complicated by the presence of lesions in subcutaneous skin layers. These diagnostic challenges can contribute to misdiagnosis and/or delayed diagnosis and appropriate intervention. The average time from symptom onset to accurate diagnosis is 7 to 10 years, at which point the disease has typically reached a severe stage. […] A delayed diagnosis, and therefore a delay in appropriate treatment, can result in uncontrolled disease activity, including fibrosis and scarring, and sinus tract formation. At this stage, the scarring and tunnels are often irreversible. Patients may also experience a reduced quality of life and resistance to treatment. Early diagnosis and treatment are essential for patients with HS. Early treatment targets reversible lesions, and it may be associated with improved treatment outcomes. Importantly, treating during what we call this window of opportunity may halt the progression of HS before patients develop irreversible scars and/or diminished quality of life.
  • #2 Diagnosing Hidradenitis Suppurativa | HS Awareness | HCP
    https://www.hs-awareness.com/identifying-and-diagnosing-hs
    An early diagnosis of hidradenitis suppurativa (HS) can help mitigate disease burdens. HS can be challenging to diagnose as the clinical characteristics may be difficult to identify or mistaken for other conditions. But the consequences of a delayed HS diagnosis can be damaging and may even be permanent. Recognizing the characteristic lesions of HS and how they present across different skin tones can help get patients the care they need to help inhibit further disease progression. […] There are 3 essential diagnostic criteria that can help distinguish HS from other skin conditions. […] One or more painful, inflammatory, deep-seated nodules, abscesses, or comedones. […] Lesions are most common on flexural sites, like the axillae, inframammary, groin, perineal and perianal regions. They are less common on ears, face, scalp, back, chest, or legs.
  • #2 Hidradenitis Suppurativa: Practice Essentials, Pathophysiology, Etiology
    https://emedicine.medscape.com/article/1073117-overview
    Hidradenitis suppurativa (HS) is a disorder of the terminal follicular epithelium in the apocrine glandbearing skin. […] The diagnosis is primarily clinical, no pathognomonic test exists, and biopsy is rarely required, especially in well-developed lesions. […] The consensus approach indicates that three key elements are required to diagnose HS: typical lesions, characteristic distribution, and recurrence. […] All three criteria must be present for the definitive diagnosis. […] Primary positive diagnostic criteria are as follows: History – Recurrent painful or suppurating lesions more than twice in 6 months. […] The axillae and the groin are the two areas most frequently affected. […] HS is diagnosed if the patient has one of the following: Active disease with one or more primary lesions in a designated site, plus a history of three or more discharging or painful lumps (not specified) in designated sites since age 10 years.
  • #2 Hidradenitis Suppurativa (HS) Clinical Diagnosis Criteria
    https://www.hsdiseasesource.com/hs-diagnosis-criteria
    Hidradenitis suppurativa (HS) may present in various phenotypes, making diagnosis challenging. Early diagnosis may help improve HS prognosis and prevent extensive and irreversible subdermal damage and scarring. […] The diagnosis of HS is a clinical one using 3 key criteria. No confirmatory laboratory tests exist. […] HS lesions typically present in at least 1 of these locations: axilla, groin, genitals, buttocks, or under the breasts. Other areas may include the neck or abdomen. […] Lesions tend to recur in the affected regions characteristic of HS. Sometimes lesions may recur in the same anatomical location of the body, occur in a different location, or both. […] Two or more recurrences of symptoms over a period of 6 months may be indicative of HS and often referred to as flares or flareups.
  • #2 Hidradenitis Suppurativa (Acne Inversa): Symptoms & Treatments
    https://my.clevelandclinic.org/health/diseases/17716-hidradenitis-suppurativa
    Hidradenitis suppurativa (HS) is a condition that causes painful, recurring boils in areas of your body with sweat glands. There isn’t a cure, but treatment can help manage symptoms and prevent new boils and scarring. […] A dermatologist has special training that helps them recognize the signs of hidradenitis suppurativa. […] A review of your health history and a physical exam is typically all that’s necessary. […] Hidradenitis suppurativa treatment depends on the severity of your symptoms. […] Other medications that help people with hidradenitis suppurativa include: Adalimumab, a biologic therapy that quiets your body’s immune system response. This can ease inflammation. […] If you have severe symptoms or growths that don’t respond to other therapies, you may need a procedure. […] Hidradenitis suppurativa (HS) is a painful condition that causes recurrent painful draining boils and can lead to scarring. If you have painful boils that last for weeks and keep coming back in the other areas mentioned above, please see a healthcare provider.
  • #2 Hidradenitis suppurativa: Diagnosis and treatment
    https://www.aad.org/public/diseases/a-z/hidradenitis-suppurativa-treatment
    Talk with you about what they see on your skin. During this talk, your dermatologist will ask you about your symptoms, when the bumps and sores appeared, and other specifics. This information helps your dermatologist give you an accurate diagnosis. […] If you have a sore thats leaking fluid, your dermatologist may swab a bit of the fluid so that it can be tested. This test can tell your dermatologist whether you have an infection. […] If you have hidradenitis suppurativa, your dermatologist will create a treatment plan tailored to your needs.
  • #2 Improving the Differential Diagnosis of Hidradenitis Suppurativa – Dermatology Advisor
    https://www.dermatologyadvisor.com/cch/hidradenitis-suppurativa-differential-diagnosis-severity-scores/
    Hidradenitis suppurativa (HS) is a chronic, painfully debilitating skin condition. […] Despite its severe impact on quality of life, HS is plagued by a delay in accurate diagnosis, estimated globally at more than 7 years. […] In general, HS is diagnosed by dermatologists; however, patients often consult several physicians for years before receiving a correct diagnosis. […] The diagnosis of HS is clinical. A full-body skin examination is required to assess the extent and severity of HS and determine the treatments impact. […] A definitive diagnosis requires all 3 of the following criteria to be present: Typical deep-seated painful nodules, often described as blind boils, must be present. […] Clinical examination alone, however, may underestimate the severity and disease involvement of HS.
  • #2 Hidradenitis suppurativa (HS)
    https://www.nhs.uk/conditions/hidradenitis-suppurativa/
    There’s no definitive test to help diagnose hidradenitis suppurativa. […] A GP will examine the affected areas of skin, and they may take a swab of an infected area. This can be helpful in making a diagnosis because the condition is not usually associated with the presence of bacteria that cause skin infections. […] Hidradenitis suppurativa could be mistaken for acne or ingrown hairs.
  • #2 Hidradenitis Suppurativa (Acne Inversa): A Complete Picture – DermNet
    https://dermnetnz.org/topics/hidradenitis-suppurativa
    How is hidradenitis suppurativa diagnosed? The diagnosis of acne inversa requires all three components of the triad to be met: Characteristic lesions, Typical distribution, Presence and recurrence of lesions. […] Swabs for bacteriology are typically negative, which is a clue to diagnosis. Extensive investigations are rarely required. Investigations may be indicated to exclude a differential diagnosis, for possible complications, to identify comorbidities, or for planned treatment.
  • #2 Hidradenitis Suppurativa Diagnosis: Physical Exam, Ultrasound, and More | myHSteam
    https://www.myhsteam.com/resources/hidradenitis-suppurativa-hs-the-path-to-diagnosis
    Your dermatology team will typically evaluate three primary factors when diagnosing HS: Recurring hidradenitis suppurativa lesions, A family history of the condition, Other possible conditions that can be ruled out. […] Currently, there is no single test for diagnosing hidradenitis suppurativa. However, doctors may use various tests to support and rule out other conditions. […] Your doctor will also conduct a thorough review of your medical history, asking about HS symptoms over time and family medical history. This history can provide a clearer picture that strengthens the suspicion of HS or rules out other conditions. […] Your doctor will conduct a thorough exam of your skin symptoms to determine if theyre consistent with hidradenitis suppurativa. […] Your doctor may perform an ultrasound during the HS diagnosis process. This may help your dermatologist detect symptoms like lesions and tunnels that arent visible to the eye.
  • #2 How to Diagnose Hidradenitis Suppurativa (HS)
    https://www.verywellhealth.com/how-to-diagnose-hidradenitis-suppurativa-11685076
    Additionally, if there’s any concern that you might have another skin condition besides hidradenitis suppurativa, you may need a skin biopsy procedure to take a skin sample for examination in the lab. […] The characteristic features of hidradenitis suppurativa can help distinguish it from other diseases. […] Your healthcare provider might classify your disease stage, which can help provide an objective way to assess whether your condition is getting worse over time or improving with treatment. […] Usually, a dermatologist diagnoses this condition with a visual skin examination, but sometimes, tests can help rule out other conditions, like cancer or an infection.
  • #2 Hidradenitis suppurativa diagnosis and management in primary care: not just recurrent boils | British Journal of General Practice
    https://bjgp.org/content/73/726/43
    Hidradenitis suppurativa (HS) is characterised by inflamed skin lesions and scars that occur in apocrine-gland-bearing areas including axillae, inframammary folds, and groin, with a chronic course including flares. […] HS significantly impacts general health and quality of life. […] Practitioners in primary care can both diagnose and treat early disease. […] Three main elements need to be considered in a diagnosis of HS: skin changes, locations of lesions, and duration. […] There is no specific investigation to diagnose HS. […] Treatments for HS can be started in primary care. […] Monitoring for comorbidities should be carried out and annual screening is recommended for cardiovascular disease, obesity, tobacco and alcohol use, psychological disorders, inflammatory bowel disease, and inflammatory arthropathies.
  • #2 Hidradenitis Suppurativa: Practice Essentials, Pathophysiology, Etiology
    https://emedicine.medscape.com/article/1073117-overview
    The Hurley clinical staging of HS from 1989 is still relevant today; it has diagnostic value but is not suitable for monitoring the efficacy of interventions in clinical trials. […] The HS clinical response (HiSCR), defined as at least a 50% reduction in total abscess and inflammatory nodule count with no increase in abscess count and no increase in draining fistula count relative to baseline at week 12, is the most appropriate clinical end point for assessing treatment effectiveness.
  • #2 Hidradenitis Suppurativa Workup: Laboratory Studies, Imaging Studies, Other Tests
    https://emedicine.medscape.com/article/1073117-workup
    The Hurley clinical staging of HS was developed in 1989 but remains relevant today; it has diagnostic value but is not suitable for monitoring the efficacy of interventions in clinical trials. […] The HS clinical response (HiSCR), defined as at least a 50% reduction in total abscess and inflammatory nodule count with no increase in abscess count and no increase in draining fistula count relative to baseline at week 12, is the most appropriate clinical end point for assessing treatment effectiveness.
  • #2 Uncovering Common Misdiagnoses Of Hidradenitis Suppurativa
    https://hsfoundation.ca/misdiagnoses-of-hidradenitis-suppurativa/
    HS is a chronic inflammatory skin condition that can be misdiagnosed due to its similarity to other skin conditions. […] The misdiagnosis can cause delayed treatment, worsening of the condition, and unnecessary interventions. […] Clinicians should be aware of the common misdiagnoses of HS and consider the possibility of HS in patients with recurrent skin lesions in the skin folds. […] Early and accurate diagnosis of HS can lead to better outcomes and improved quality of life for patients.
  • #2 Hidradenitis Suppurativa Differential Diagnosis and Mimickers | Plastic Surgery Key
    https://plasticsurgerykey.com/hidradenitis-suppurativa-differential-diagnosis-and-mimickers/
    The average length of time from onset to diagnosis in hidradenitis suppurativa (HS) patients worldwide is 7.2 years. This unfortunate delay is partly because of the nonspecific nature of many HS lesionsinflammatory papules, nodules, pustules, abscesses, and scarringwhich may be confused with a variety of other cutaneous diseases. […] Although there are a number of conditions that can mimic HS in their clinical appearance, HS can usually be accurately diagnosed on the basis of its chronic and recurrent history, typical anatomic locations, nonspecific bacterial culture results, and lack of systemic signs and symptoms. […] It is important to note that the differential diagnosis may differ for early HS compared to late HS, and for adult HS compared to pediatric HS. Overall, the differential diagnosis of HS includes both follicular and non-follicular conditions of infectious, inflammatory, and neoplastic origin.
  • #2 Diagnosis & Treatment Obstacles: Hidradenitis Suppurativa | CCID
    https://www.dovepress.com/obstacles-to-early-diagnosis-and-treatment-of-hidradenitis-suppurativa-peer-reviewed-fulltext-article-CCID
    In the pediatric population, delay in diagnosis has been shorter. […] Due to the progressive nature of HS, timely diagnosis is paramount in improving patient quality of life. […] Patients with HS, on average, see more than three different physicians and undergo more than three misdiagnoses before finally receiving the correct diagnosis of HS, which is commonly made by a dermatologist. […] While HS is often primarily managed by dermatology once the diagnosis has been established, it is vital for non-dermatologic providers to be aware of this condition. […] In a 2021 survey of 211 family medicine physicians, only 23.7% reported feeling confident in diagnosing HS. […] The diagnosis of HS is often delayed by 3 to 12 years, and patients, particularly those who are non-white, female, or have more severe symptoms, may experience 3 to 4 misdiagnoses before receiving an accurate diagnosis.
  • #2 Hidradenitis Suppurativa Diagnosis | Hidradenitis Suppurativa
    https://resources.healthgrades.com/right-care/hidradenitis-suppurativa/why-it-can-take-some-time-for-a-hidradenitis-suppurativa-diagnosis
    Chronic skin conditions affect millions of Americans, but some are more well known than others. One of these lesser-known conditions, hidradenitis suppurativa (HS), involves painful lumps that form under the skin and cause distressing symptoms that interfere with everyday life. […] Although treatment can help, it can be extremely difficult to receive an accurate hidradenitis suppurativa diagnosis. The diagnostic process often takes a long time. But it’s important to stick with it; working closely with your doctor is ultimately the best way to identify the condition and find which treatments work best for you. […] Unfortunately, the symptoms of HS, especially initial symptoms, often resemble other medical conditions. There are no immediate telltale features that illuminate the diagnosis. Doctors often mistake early hidradenitis suppurativa for cysts, painful pimples, or boils. It’s also common to misdiagnose HS as folliculitis, or infection of the hair follicles. In some cases, the symptoms of HS may mimic certain sexually transmitted diseases.
  • #2 Hidradenitis Suppurativa (HS) Differential Diagnosis
    https://www.hsdiseasesource.com/hs-differential-diagnosis
    Many patients experience significant delays in receiving a diagnosis of hidradenitis suppurativa (HS). This is often due to: […] Prompt, accurate diagnosis can aid in the initiation of proper treatment and help prevent the progression to more debilitating stages. […] Patients experience a significant delay in receiving an HS diagnosis. […] Average time to diagnosis is 7-10 years. […] Patients may have more than 17 visits before receiving a correct diagnosis. […] 4 to 5 physicians may be seen prior to an accurate HS diagnosis. […] Patients wait an average of 2.3 years before first presenting to a physician. […] It’s critically important to diagnose HS early and intervene with medical therapies given the progressive, irreversible nature of the disease.
  • #2 Overview and Diagnosis of Hidradenitis Suppurativa (HS)
    https://www.hcplive.com/view/overview-and-diagnosis-of-hidradenitis-suppurativa-hs
    Why is early treatment important? It is imperative because once these patients have had sinus tract formation, scarring, or surgical intervention, it is so hard to get them to a better baseline. So its really important to begin earlier rather than later so it can increase their overall quality of life prior to having some of those irreversible procedures and scarring with sinus tracts.
  • #2 Hidradenitis suppurativa: Overview
    https://www.aad.org/public/diseases/a-z/hidradenitis-suppurativa-overview
    During their first appointment with a dermatologist, patients with hidradenitis suppurativa (HS) often say they have pimples, sores, or lumps on their armpits or groin. […] Dermatologists are the doctors who specialize in the diagnosis and treatment of this condition. […] If you have any of these signs and have not seen a dermatologist, make an appointment. Dermatologists specialize in diagnosing and treating the skin and can tell you whether you have HS. […] Many people live years with HS before being diagnosed. […] According to a study conducted in Canada, some people return to the ER 10 or more times before getting diagnosed with HS. Thats why its important to see a board-certified dermatologist. […] To a dermatologists trained eye, there are differences between HS and other conditions like acne and boils. Dermatologists receive the training needed to spot these differences.
  • #2 Hidradenitis suppurativa diagnosis and management in primary care: not just recurrent boils | British Journal of General Practice
    https://bjgp.org/content/73/726/43
    Criteria for referral to secondary care include: Patients who fail to gain control of their symptoms with the therapies already suggested; Severe disease (Hurley stage 3) present at diagnosis or multiple areas involved, numerous nodules, and tunnelling; Significant impact on their quality of life; and When the diagnosis is in question and further assessment is required.
  • #2 Hidradenitis Suppurativa (HS) | HS Awareness | HCP
    https://www.hs-awareness.com/about-hs
    HS is widely under-recognized. This can cause diagnostic delays that can facilitate disease progression and long-lasting negative effects on a patient’s quality of life. Knowing fact from fiction about HS can help get patients the accurate diagnosis and treatment they promptly need. […] Given the numerous comorbidities associated with HS, management coordinated between a multidisciplinary care team should be based on the individual.
  • #2 Hidradenitis Suppurativa Diagnosis May Be Predicted and Supported By Machine Learning Model
    https://www.dermatologytimes.com/view/hidradenitis-suppurativa-diagnosis-may-be-predicted-and-supported-by-machine-learning-model
    Machine learning is increasingly being used to aid in disease recognition, including of HS. […] The primary results revealed that high-performing machine learning models for predicting HS diagnosis can be built using claims data, with top models achieving diagnostic accuracies of up to 65% to 73% and an area under the curve of 81% to 82%. […] The sensitivity analysis and validation results show that shorter timeframes around the index date yield comparable performance metrics for predicting HS, suggesting that shorter data periods are reliable for model development in claims analyses. […] An exploratory application revealed significant underdiagnosis of HS among patients with abscess or cellulitis, varying by metropolitan statistical area and model used. This suggested that implementing machine learning models could help health systems identify patients with undiagnosed HS for further evaluation and research.
  • #2 Diagnostic Criteria for Hidradenitis Suppurativa May Overlook Pediatric Patients
    https://www.ajmc.com/view/diagnostic-criteria-for-hidradenitis-suppurativa-may-overlook-pediatric-patients
    More than a third (42.8%) of pediatric patients with hidradenitis suppurativa did not meet all major diagnostic criteria at the time of diagnosis, particularly due to failure to fulfill the recurrence interval criterion (2 or more lesions within 6 months). […] Consensus-derived diagnostic criteria for HS exist to guide accurate clinical diagnosis, which has shown applicability for adult patients, noted researchers. But these criteria have not been evaluated in pediatric patients, despite most patients reporting onset of HS during adolescence. […] Documentation from the diagnostic visit indicated that major diagnostic criteria were fulfilled in 170 (57.2%) patients and 127 (42.8%) patients did not meet all 3 major HS diagnostic criteria. Of those who did not fulfill HS diagnostic criteria, 122 (96.1%) did not meet the recurrence interval criterion (2 or more lesions within 6 months), followed by 4 patients who did not have a typical lesion and 3 who did not have a typical affected location. […] They concluded that future prospective studies are warranted to determine if revisions to the HS diagnostic criteria are needed to facilitate timely HS diagnosis in a pediatric population.
  • #2
    https://link.springer.com/article/10.1007/s13555-024-01291-0
    Moreover, patients with a family history of HS were diagnosed quicker, whereas those with high body mass index, more concomitant conditions, in employment, managed by multiple physicians or European were more delayed. […] On the basis of a thorough analysis of real-world data, multiple factors that potentially influenced the timely diagnosis of HS have been identified. […] This study quantifies the relative impact of these modifiers, providing valuable insights into areas that require attention for faster diagnoses and improved disease outcomes.
  • #2 5 Ways You Can Advocate for a Hidradenitis Suppurativa Diagnosis | SELF
    https://www.self.com/story/hidradenitis-suppurativa-diagnosis-advocacy
    Hidradenitis suppurativa is not going to go away on its own, Dr. Martin says. […] If youre not doing some preventative care to treat the underlying disease, then youre just putting on a Band-Aid. […] If you think your unexplained skin symptoms might be pointing to hidradenitis suppurativa, here are five things you can do to receive a proper diagnosis and treatment plan you feel comfortable with. […] If youre concerned that your symptoms might be pointing to hidradenitis suppurativa, then seeing a dermatologist will be your best bet in getting an accurate diagnosis. […] This can sometimes make things a bit tricky, as many family doctors may not be as familiar with HS or might not have gone through a lot of dermatology training during medical school, Dr. Martin explains. […] If you have a doctor who you feel comfortable talking to but theyre not an obvious hidradenitis suppurativa expert, like an ob-gyn, then you may want to make an appointment with them anyway, says Dr. Martin.
  • #2 Tests for Hidradenitis Suppurativa: Getting a Diagnosis
    https://www.health.com/hidradenitis-suppurativa-diagnosis-8663425
    Hidradenitis suppurativa (HS) can be difficult to diagnose because its symptoms often resemble symptoms of other conditions, such as acne, infections, or insect bites. Currently, no specific diagnostic test can definitively determine if you have HS. Because of this, many people with HS don’t receive a diagnosis in the early stages of the condition. […] In most cases, your healthcare team (which may include your primary care provider and dermatologist) will use several exams including a physical exam, blood tests, and imaging scans to determine whether you have HS and understand the severity of your condition. […] No single test can diagnose HS, so healthcare providers use a combination of a physical exam, blood tests, and imaging scans to rule out other conditions and make an accurate diagnosis.
  • #2 What Are the Diagnostic Criteria for HS? | Consultant360
    https://www.consultant360.com/exclusives/etiology-and-diagnosis-hidradenitis-suppurativa
    The first part in this 3-part series gives an overview of hidradenitis suppurativa and discuss the disease’s etiology and diagnosis. […] Hidradenitis suppurativa (HS) is a challenging disease for both patients and practitioners given its debilitating nature, its comorbidities, and the complex nature of effective treatment options. […] HS is a clinical diagnosis that can be a challenge. Three diagnostic criteria must be present for definitive diagnosis: The presence of typical lesions of deep-seated painful nodules (known as blind boils without a purulent point) in early lesions and abscesses, sinuses, bridged scars, and tombstone open comedones (pseudocomedones) in secondary lesions. Lesions occurring in at least 1 typical body location such as the axillae, groin, perineal and perianal region, buttocks, and inframammary and intermammary folds. Chronic nature of disease, relapses, and recurrences.
  • #2 Hidradenitis suppurativa: Overview
    https://www.aad.org/public/diseases/a-z/hidradenitis-suppurativa-overview
    With an accurate diagnosis and proper treatment for HS, you can: Prevent HS from worsening, Relieve pain, Improve wound healing, Treat an infection, which can develop if you have an open wound. […] When you see a dermatologist for HS, your dermatologist will create a treatment plan tailored to your needs and watch your health closely.
  • #3 Hidradenitis Suppurativa (HS) Differential Diagnosis
    https://www.hsdiseasesource.com/hs-differential-diagnosis
    Many patients experience significant delays in receiving a diagnosis of hidradenitis suppurativa (HS). This is often due to: […] Prompt, accurate diagnosis can aid in the initiation of proper treatment and help prevent the progression to more debilitating stages. […] Patients experience a significant delay in receiving an HS diagnosis. […] Average time to diagnosis is 7-10 years. […] Patients may have more than 17 visits before receiving a correct diagnosis. […] 4 to 5 physicians may be seen prior to an accurate HS diagnosis. […] Patients wait an average of 2.3 years before first presenting to a physician. […] It’s critically important to diagnose HS early and intervene with medical therapies given the progressive, irreversible nature of the disease.
  • #3 What Are the Diagnostic Criteria for HS? | Consultant360
    https://www.consultant360.com/exclusives/etiology-and-diagnosis-hidradenitis-suppurativa
    The first part in this 3-part series gives an overview of hidradenitis suppurativa and discuss the disease’s etiology and diagnosis. […] Hidradenitis suppurativa (HS) is a challenging disease for both patients and practitioners given its debilitating nature, its comorbidities, and the complex nature of effective treatment options. […] HS is a clinical diagnosis that can be a challenge. Three diagnostic criteria must be present for definitive diagnosis: The presence of typical lesions of deep-seated painful nodules (known as blind boils without a purulent point) in early lesions and abscesses, sinuses, bridged scars, and tombstone open comedones (pseudocomedones) in secondary lesions. Lesions occurring in at least 1 typical body location such as the axillae, groin, perineal and perianal region, buttocks, and inframammary and intermammary folds. Chronic nature of disease, relapses, and recurrences.
  • #3 Hidradenitis Suppurativa | Acne Inversa | MedlinePlus
    https://medlineplus.gov/hidradenitissuppurativa.html
    Hidradenitis suppurativa (HS) is a chronic skin disease. […] There is no specific test for HS. It can be hard to diagnose in the early stages because it can look like pimples or acne. To make a diagnosis, your health care provider: Will ask about your medical history and your symptoms, Will look at the lumps on your skin, May take a sample of the skin or pus (if there is any) and send it to a lab to be tested. […] Your provider may refer you to a dermatologist (skin doctor) to get a diagnosis or treatment.
  • #3 Management of hidradenitis suppurativa: an Australasian consensus statement
    https://dermnetnz.org/topics/hidradenitis-suppurativa-guidelines
    Objective staging and scoring of HS can guide the approach to treatment and assist in monitoring outcomes. […] The Hurley classification is a static grading system, well established amongst dermatologists. […] The Hidradenitis Suppurativa Clinical Response (HiSCR) is a dynamic categorical score defined as a 50% reduction in inflammatory lesion count (sum of abscesses and inflammatory nodules) and no increase in abscesses or draining fistulae when compared with baseline. […] The routine use of patient-reported outcomes including the Dermatology Life Quality Index (DLQI) and simple visual analogue measures of itch and pain can assist in monitoring the impact of the disease and refining treatment.
  • #3 Hidradenitis Suppurativa Diagnosis: Physical Exam, Ultrasound, and More | myHSteam
    https://www.myhsteam.com/resources/hidradenitis-suppurativa-hs-the-path-to-diagnosis
    Several skin conditions can cause symptoms similar to hidradenitis suppurativa. The process of ruling out other conditions with similar signs and symptoms is known as differential diagnosis. […] Confirming an HS diagnosis and ruling out other potential causes of skin lesions allows for a more accurate management of hidradenitis suppurativa. After diagnosis, your doctor may assess the severity of your HS and assign a stage using a scoring system like the Hurley staging system. This is essential in guiding the best surgical approach and other treatment options.
  • #3 Diagnosis & Treatment Obstacles: Hidradenitis Suppurativa | CCID
    https://www.dovepress.com/obstacles-to-early-diagnosis-and-treatment-of-hidradenitis-suppurativa-peer-reviewed-fulltext-article-CCID
    In the pediatric population, delay in diagnosis has been shorter. […] Due to the progressive nature of HS, timely diagnosis is paramount in improving patient quality of life. […] Patients with HS, on average, see more than three different physicians and undergo more than three misdiagnoses before finally receiving the correct diagnosis of HS, which is commonly made by a dermatologist. […] While HS is often primarily managed by dermatology once the diagnosis has been established, it is vital for non-dermatologic providers to be aware of this condition. […] In a 2021 survey of 211 family medicine physicians, only 23.7% reported feeling confident in diagnosing HS. […] The diagnosis of HS is often delayed by 3 to 12 years, and patients, particularly those who are non-white, female, or have more severe symptoms, may experience 3 to 4 misdiagnoses before receiving an accurate diagnosis.
  • #3
    https://link.springer.com/article/10.1007/s13555-024-01291-0
    Patients with hidradenitis suppurativa (HS) experience significantly delayed diagnoses of 7-10 years from symptom onset on average, but the reasons for this remain largely unknown. […] Factors influencing delay to HS diagnosis in the literature with the most available evidence were misdiagnosis, delay in specialist referral and patient embarrassment. […] Data analysis revealed that increasing age was associated with reduced diagnostic delay after symptom onset. […] Patients with HS who were White or in Germany were also more likely to receive a faster diagnosis. […] Smokers, patients with concomitant conditions, or a family history of HS were slower to be diagnosed. […] When time to diagnosis following first consultation was assessed, increasing age was associated with quicker diagnosis.
  • #3 5 Ways You Can Advocate for a Hidradenitis Suppurativa Diagnosis | SELF
    https://www.self.com/story/hidradenitis-suppurativa-diagnosis-advocacy
    You can ask about their familiarity with the condition and request a referral to a dermatologist if necessary. […] Symptoms dont usually go away 100%, so I also like to talk about goals of treatment, Dr. Martin says. […] If your physician doesnt ask, tell them what your specific goals are, whether its less interruption of sleep, being able to exercise without pain, or wearing the type of clothes you want. […] Its important to discuss and understand the pros and cons of each of these treatments, including effectiveness, side effects, and cost, Dr. Martin says. […] Then I see patients again after weve given our initial treatment some time to work, deciding if they would like to stay with their current routine, or change or add additional treatment.

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