Hidradenitis Suppurativa — SCE Dermatology MCQ

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ModerateInflammatory DermatosesHidradenitis SuppurativaSCE Dermatology

A 32-year-old woman presents with recurrent deep-seated abscesses in her axillae and groin. She has sinus tract formation and scarring (Hurley stage II). What validated scoring system is used to assess hidradenitis suppurativa severity for clinical trials?

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Correct answer: C — IHS4 (International HS Severity Score)

The IHS4 (International Hidradenitis Suppurativa Severity Score System) is a validated, dynamic scoring tool calculated by counting inflammatory nodules, abscesses, and draining tunnels, weighted differently. IHS4 = (number of nodules × 1) + (number of abscesses × 2) + (number of draining tunnels × 4). Mild ≤3; Moderate 4-10; Severe ≥11. HiSCR (50% reduction in inflammatory nodule count, no increase in abscesses/draining fistulae) is the standard binary outcome measure used in clinical trials. Hurley staging (I-III) provides a static classification. DLQI measures quality of life impact.

Reference: BAD 2019 HS Guidelines; IHS4 Zouboulis 2017