Maryam Razavi

maryam.razavi@cambio.se

CambioCDS

To Quantify severity of psoriasis.

Use in patients with psoriasis. Use with caution in patients with smaller areas of involvement, as the score is less sensitive in those cases. Variables: Lesion characteristic (separately scored for head/neck, upper limbs, trunk, and lower limbs) and points: - Erythema: None= 0 Slight= 1 Moderate= 2 Severe= 3 Very severe= 4 - Induration/thickness: None= 0 Slight= 1 Moderate= 2 Severe= 3 Very severe= 4 - Desquamation/scaling: None= 0 Slight= 1 Moderate= 2 Severe= 3 Very severe= 4 Percentage of area affected and points: 0%=0, 1-9%=1, 10-29%=2, 30-49%=3, 50-69%=4, 70-89%=5, 90-100%=6 Note: Validated using palm method of body surface area estimation (patient’s palm, excluding fingers, roughly correlates to 1% BSA). Body surface area: Region and Constants Head/neck= 0.1 Upper limbs= 0.2 Trunk= 0.3 Lower limbs= 0.4 Interpretation: Higher PASI scores indicate higher severity of psoriasis. Scores range from 0 (no disease) to 72 (maximal disease severity).

Calculating the PASI can be error-prone if not done systematically.

1. Fredriksson T, Pettersson U. Severe psoriasis--oral therapy with a new retinoid. Dermatologica. 1978;157(4):238-44. 2.Langley RG, Ellis CN. Evaluating psoriasis with Psoriasis Area and Severity Index, Psoriasis Global Assessment, and Lattice System Physician's Global Assessment. J Am Acad Dermatol. 2004;51(4):563-9. 3. Schmitt J, Wozel G. The Psoriasis area and severity index is the adequate criterion to define severity in chronic plaque-type psoriasis. Clinical and Laboratory Investigations. 2005; 210: 194-199. 4. Feldman SR, Krueger GG. Psoriasis assessment tools in clinical trials. Ann Rheum Dis. 2005; 64: 65-68. 5. Berth-Jones J, Grotzinger K, Rainville C et al. A study examining inter- and intrarater reliability of three scales for measuring severity of psoriasis: Psoriasis Area and Severity Index, Physicians Global Assessment and Lattice System Physicians Global Assessment. Clinical and Laboratory Investigations. 2006; 155: 707-713. 6. Spuls PI, Lecluse LLA, Poulsen MNF et al. How Good are Clinical Severity and Outcome Measures for Psoriasis?: Quantitative Evaluation in a Systematic Review. Journal of Investigative Dermatology. 2010; 130 (4): 933-943. 7. Puzenat E, Bronsard V, Gourraud PA et al. What are the best outcome measures for assessing plaque psoriasis severity? A systematic review of the literature. European Academy of Dermatology and Venereology. 2010; 24: 10-16. 8. Simpson MJ, Chow C, Morgenstem H et al. Comparison of 3 methods for measuring psoriasis severity in clinical studies (Part 2 of 2): use of quality of life to assess construct validity of LS-PGA, PASI and Static Physician’s Global assessment. European Academy of Dermatology and Venereology. 2015; 29: 1415-1420. 9. Mrowietz U, Kragballe K, Reich K, et al. Definition of treatment goals for moderate to severe psoriasis: a European consensus. Arch Dermatol Res. 2011;303(1):1-10. 10. Australiasian College of Dermatologists. The Australasian College of Dermatologist Consensus Statement. Treatment goals for psoriasis 2017. https://www.dermcoll.edu.au/wp-content/uploads/ACD-Consensus-Statement-Treatment-goals-for-psoriasis-March-2017.pdf. Accessed March 19, 2019. 11. Elmets CA, Leonardi CL, Davis DMR, et al. Joint AAD-NPF guidelines of care for the management and treatment of psoriasis with awareness and attention to comorbidities. J Am Acad Dermatol. 2019;80(4):1073-1113.

OBSERVATION.pasi.v0