This protocol addresses adult patients (non-pregnant) with hidradenitis suppurativa classified at Hurley stage II — defined by 1 or a limited number of sinuses and/or scarring confined to a single body region.

Clinical Staging Context

Hurley stage II is an intermediate classification. It is distinguished from stage I — recurrent nodules and abscesses with minimal scarring — and from stage III, which involves multiple or extensive sinuses and widespread scarring. Accurate staging is essential for selecting the appropriate treatment approach.

Treatment Approach (Partial)

The structured regimen for this population includes biologic agents and, where indicated, a targeted combination antibiotic strategy. Each option carries specific selection criteria and a defined sequencing logic.

Complete dosing guidance, the full list of options, sequencing algorithm, and clinical decision criteria are available in the protocol below →

References

Hurley stage I is characterized by recurrent nodules and abscesses with minimal scar, Hurley stage II is characterized by 1 or a limited number of sinuses and/or scarring within a body region, and Hurley stage III is characterized by multiple or extensive sinuses and/or scarring.
Adalimumab at the approved HS dosing is recommended to improve disease severity and quality of life in patients with moderate-to-severe HS.
Infliximab is recommended for moderate-to-severe disease; however, dose-ranging studies are needed to determine the optimal dosage for management.
Moxifloxacin, metronidazole, and rifampin in combination are recommended as second- or third-line treatment in moderate-to-severe disease.

DOI: 10.1016/j.jaad.2019.02.067

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What Is the Treatment of Hidradenitis Suppurativa at Hurley Stage II in Adult Patients?

References