Ohkarwara developed a classification for describing the clinical severity of generalized pustular psoriasis (GPP).
Clinical parameters:
(1) erythema
(2) pustules
(3) confluent pustules
(4) enanthema (an eruption on a mucosal surface)
|
Clinical Parameter |
Findings |
Points |
|
erythema |
absent |
0 |
|
|
part of skin (focal) |
1 |
|
|
about 50% of BSA |
2 |
|
|
generalized |
3 |
|
pustules |
absent |
0 |
|
|
part of skin (focal) |
1 |
|
|
about 50% of BSA |
2 |
|
|
generalized |
3 |
|
confluent pustules |
absent |
0 |
|
|
present |
1 |
|
enanthema |
absent |
0 |
|
|
present |
1 |
total score for clinical parameters =
= SUM(points for all 4 clinical parameters)
Rating parameters for disease severity:
(1) total score for clinical parameters (above)
(2) fever
(3) erythrocyte sedimentation rate (ESR)
(4) white blood cell count (WBC count)
(5) serum albumin
(6) serum calcium
|
Rating Parameter |
Findings |
Points |
|
total clinical score |
<= 2 |
0 |
|
|
3 - 5 |
1 |
|
|
>= 6 |
2 |
|
fever |
< 38°C |
0 |
|
|
38 - 39°C |
1 |
|
|
> 39°C |
2 |
|
ESR |
< 30 mm/h |
0 |
|
|
30 - 59 mm/h |
1 |
|
|
>= 60 mm/h |
2 |
|
WBC count |
< 10,000 per µL |
0 |
|
|
10,000 - 14,999 per µL |
1 |
|
|
>= 15,000 per µL |
2 |
|
serum albumin |
>= 3.5 g/dL |
0 |
|
|
<= 3.4 g/dL |
1 |
|
serum calcium |
>= 8.3 mg/dL |
0 |
|
|
<= 8.2 mg/dL |
1 |
total rating score =
= SUM(points for all 6 parameters)
Interpretation:
• minimum clinical score: 0
• maximum clinical score: 8
• minimum rating score: 0
• maximum rating score: 10
|
Total Rating Score |
Disease Activity |
|
<= 2 |
mild |
|
3 to 6 |
moderate |
|
>= 7 |
severe |
Specialty: Dermatology, Immunology/Rheumatology
