The Dermatology Index of Disease Severity (DIDS) rates the severity of inflammatory cutaneous disease using body surface area involvement and extent of functional limitations.
If more than one skin condition is present, each should be assessed separately.
Body Surface Area (BSA) Involvement
Percent of BSA
head and neck
entire trunk (chest, abdomen, back), excluding buttocks
both legs including buttocks
(1) active disease dispersed over a region should be mentally compressed into a single confluent area of involvement; a widely dispersed disease may actually involve only a small percent of body surface area
(2) only inflammatory disease active at the current visit should be evaluated
(3) areas of post-inflammatory hyperpigmentation or scarring are not included
Performance of activities of daily living or functioning is the second component of staging in the DIDS.
(1) related to the active cutaneous disease as observed today
(2) does not utilize historical restrictions
(3) does not include restriction due to associated processes such as arthritis
moderate functional limitation:
(1) clearly reduced or great difficulty in activities
(2) does not require either mechanical or human assistance to perform task
severe functional limitation:
(1) unable to perform task without human or mechanical assistance
Body Surface Involveed
5.1 to 19.9%
mild to moderate
20 to 90%
Functional Impairment involves functional limitation secondary to hand, foot or mucous membrane involvement.
(1) moderate: no external mechanical and/or human assistance is required
(2) severe: external mechanical and/or human assistance is required,
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