Although dysbiosis of the cutaneous microbiome apparent in HS is not observed, the concurrent existence of inflammatory gut and skin diseases has led to the postulation of a gut-skin axis in which gut microbiota is implicated. Indeed, analysis of bacterial taxa in fecal samples from HS patients support the possibility of a role for intestinal microbial alterations in this chronic inflammatory skin disease. Diagnosis
Stages
Hidradenitis suppurativa presents itself in three stages. Due to the large spectrum of clinical severity and the severe impact on quality of life, a reliable method for evaluating HS severity is needed. Hurleys staging system
Hurleys staging system was the first classification system proposed, and is still in use for the classification of patients with skin diseases (i.e., psoriasis, HS, acne). Hurley separated patients into three groups based largely on the presence and extent of cicatrization and sinuses. It has been used as a basis for clinical trials in the past and is a useful basis to approach therapy for patients. These three stages are based on Hurleys staging system, which is simple and relies on the subjective extent of the diseased tissue the patient has. Hurleys three stages of hidradenitis suppurativa are:

Sartorius staging system
The Sartorius staging system is more sophisticated than Hurleys. Sartorius et al. suggested that the Hurley system is not sophisticated enough to assess treatment effects in clinical trials during research. This classification allows for better dynamic monitoring of the disease severity in individual patients.
Encephalomyelitis is inflammation of the brain and spinal cord. Various types of encephalomyelitis include:

Acute disseminated encephalomyelitis or postinfectious encephalomyelitis, a demyelinating disease of the brain and spinal cord, possibly triggered by viral infection. Encephalomyelitis disseminata, a synonym for multiple sclerosis. AntiMOG associated encephalomyelitis, one of the underlying conditions for the phenotype neuromyelitis optica and in general all the spectrum of MOG autoantibody-associated demyelinating diseases. Eastern equine encephalitis, Japanese encephalitis, Venezuelan equine encephalitis, and Western equine encephalitis: a group of viral illnesses that can affect horses and humans; collectively termed Equine encephalitis. Experimental autoimmune encephalomyelitis (EAE), an animal model of brain inflammation. Progressive encephalomyelitis with rigidity and myoclonus  (PERM) – A kind of stiff person syndrome. AIDS-related encephalomyelitis, caused by opportunistic Human T-lymphotropic virus type III (HTLV-III) infection. See also
Chronic fatigue syndrome, sometimes called myalgic encephalomyelitis. References


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