Assessment of disease severity and treatment effectiveness in hidradenitis suppurativa

Hidradenitis suppurativa (HS) is a chronic, disabling, inflammatory skin disorder that negatively impacts patients’ quality of life. Because of renewed scientific interest in HS, different aspects of the condition, such as disease severity assessment, are being investigated and better defined. Classically, Hurley staging classification and Sartorius score represented the milestones of disease severity evaluation. Although they show some limitations, they are widely used in both clinical trials and real practice. However, novel assessment tools and score systems have been proposed in the latest years. Attempts to create a scoring system combining physician and patient evaluation have been proposed, such as HS Severity Index (HSSI), and Acne Inversa Severity Index (AISI). Nevertheless, they have been published but not validated, conversely to a newly dynamic measurement named Hidradenitis Suppurativa Clinical Response (HiSCR). This score has been designed and proposed for assessing clinical response to treatment and its achievement may represent a valid and meaningful endpoint in the HS treatment. Up to date, no HS-specific measuring tool for the evaluation of patients’ quality of life has been designed, and, thereby, unspecific measurements gauging the disease impact on quality of life are commonly used. This review is aimed to provide an updated and comprehensive overview about the measurements available for evaluating HS disease severity and treatment effectiveness.