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Assessing Disease Progression in Hurley I Hidradenitis Suppurativa Patients: A Nested Case-Control Study
Andrea Isabel Rodriguez-Sanna1, Julia Castro-Martín1, Daniel Muñoz-Barba1
1Dermatology Department, Hospital Universitario Virgen de las Nieves, Granada, Spain.
Dermatology (Basel, Switzerland)
|February 12, 2026
Summary
This study identified factors like smoking and disease severity that predict progression in hidradenitis suppurativa (HS) patients from Hurley stage I to more severe forms. Understanding these factors can help identify at-risk individuals for early intervention.
Area of Science:
- Dermatology
- Inflammatory skin diseases
- Chronic disease progression
Background:
- Hidradenitis suppurativa (HS) is a chronic inflammatory skin condition characterized by progressive structural alterations, typically staged using the Hurley system.
- Early-stage Hurley I patients may progress to more severe forms (Hurley II-III), but the incidence and drivers of this progression are not well understood.
Purpose of the Study:
- To determine the incidence of progression from Hurley stage I to Hurley stages II and III in HS patients.
- To identify clinical features, patient habits, and interventions associated with structural progression in HS.
Main Methods:
- A retrospective cohort study of 133 Hurley I HS patients was conducted.
- A nested case-control study identified factors associated with progression using clinical and ultrasound evaluations.
- Univariate and multivariate analyses were performed to assess associations.
Main Results:
- The cumulative incidence of progression to Hurley II or III was 37.6% (50/133 patients) over the follow-up period.
- Significant independent predictors of progression included higher daily cigarette consumption, Hurley Ic stage, and increased abscess count.
- Increased abscess drainage was associated with a reduced risk of progression.
Conclusions:
- Clinical characteristics, smoking status, and treatment variables can help identify HS patients at higher risk of disease progression.
- Further research with larger cohorts is necessary to validate these predictive factors for hidradenitis suppurativa.
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