Psoriasis Series 1: Doctor, is my psoriasis serious?

This is the 4745th article of Da Yi Xiao Hu

Almost every psoriasis patient will ask: Doctor, is my condition serious? The site of onset is different for each patient, and whether the joints are involved is also different. How do you evaluate the severity of the patient's condition?

There are three most commonly used psoriasis severity scores: PASI score, BSA score, DLQI score; in addition, the PEST questionnaire is used to check whether the joints are involved. Here is how to do it~

1. PASI score: the most professional!

In this scoring, scientists summarized the key points of observing psoriasis lesions into the following four points: how red the color is, how thick the lesions are, how many scales there are, and how large the range is. In the calculation formula, the abbreviation E is how red the skin patches are, I is how thick the skin patches are, D is how many scales there are in the skin patches, and A is how much of the skin redness is. The scores for the first three range from 0 to 4 points, and the score for the last one ranges from 0 to 6 points. (Table 1)

Table 1

According to the scores in Table 1, according to the formula and weights in Table 2, the final sum is the final PASI score. A total score of less than 3 points is mild psoriasis, 3-10 points is moderate psoriasis, and more than 10 points is severe psoriasis. (Table 2)

Table 2

2. BSA rating: the simplest!

This score is the most suitable for patients to evaluate themselves. We use the size of one palm as one unit. If the skin lesions on the body are less than 3 palms in size, it is mild psoriasis, 3-10 palms in size, it is moderate psoriasis, and more than 10 palms in size, it is severe psoriasis.

3. DLQI score: depends on your mood!

DLQI is the abbreviation of Dermatology Life Quality Index. As the name suggests, it is a scoring indicator to evaluate the quality of life of friends with skin diseases. While psoriasis affects the skin of patients, it also brings great psychological pressure to everyone. Some patients do not seem to have many skin lesions, but because the lesions are in exposed parts (such as the back of the hands, face and neck, etc.), they often feel avoided by people around them and feel miserable. Scientists are also aware of this. Through questioning, they ask patients about their daily life, interpersonal relationships, symptoms and feelings, leisure, work, study, treatment, etc., and calculate the scores. Less than 5 points is mild, 6-10 points is moderate, and more than 10 points is severe. (Table 3)

Table 3

4. PEST questionnaire: look at the joints!

Psoriasis not only affects the skin, but many patients will gradually develop joint problems. There are 5 questions in the PEST questionnaire, with 1 point for a yes answer and 0 points for a no answer (Table 4). If the total score is greater than 3 points, it means that you are likely to have joint psoriasis, and the treatment plan will change.

Table 4

The severity of psoriasis and whether it is accompanied by joint problems will directly affect the formulation and modification of the treatment plan. Therefore, it is very important to accurately judge the condition. That’s all for this article. The next article will introduce treatment plans for different conditions!

Author: Yueyang Hospital of Integrated Traditional Chinese and Western Medicine affiliated to Shanghai University of Traditional Chinese Medicine

Guo Dongjie, Li Fulun