Psoriasis can show a wide range of clinical severity, with moderate and severe psoriasis representing the greater clinical challenge. Menter and Weinstein reported a working definition to identify patients who may require more aggressive management. The authors are from Baylor University and the University of California at Irvine.
Parameters:
(1) percent of body surface area (BSA) involved
(2) response to topical therapy
(3) economics of treating topically based on extent
(4) psychological distress associated with the disease
(5) ability to work
(6) type of psoriasis
Parameter |
Finding |
Points |
percent of BSA involved |
<= 20% |
0 |
|
> 20% |
1 |
response to topical therapy |
good to fair |
0 |
|
unresponsive |
1 |
economics of topical therapy |
feasible |
0 |
|
not feasible (expensive) |
1 |
psychological distress |
none or mild |
0 |
|
significant |
1 |
ability to work as a result of the psoriasis |
fully employed |
0 |
|
unable or underemployed |
1 |
type of psoriasis |
pustular or erythrodermic |
1 |
|
other |
0 |
where:
• An actor, model or other person employed for looks may be disabled because of proriasis. Psoriatric arthritis can also contribute to being unable to work at full capacity.
total score =
= SUM(number of parameters present)
Interpretation:
• minimum score: 0
• maximum score: 6
• The presence of 1 or more parameters indicates the presence of moderate-to-severe disease. The absence of parameters indicates minimal-to-mild disease.
Specialty: Dermatology, Immunology/Rheumatology