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At least 73 records · Page 4Linked to original sources
PubMed2004

A Simplified Psoriasis Area Severity Index (SPASI) for rating psoriasis severity in clinic patients.

INTRODUCTION: The Psoriasis Area and Severity Index (PASI) is the most widely used tool to assess psoriasis disease severity in clinical trials, although it can be exceedingly cumbersome for use in daily clinical practice. Because clinical trials rely on the PASI for inclusion criteria, having a PASI score on a clinic patient may be useful for determining if the patient has a level of disease severity similar to that of patients treated in clinical trials. PURPOSE: The purpose of this study is to assess a simplified measure of psoriasis disease severity that is more conducive to use in general dermatology practice, the simplified PASI (SPASI). METHODS: We evaluate an area-weighted assessment of lesion severity composed of the sum of the average redness, thickness, and scaliness of all the psoriasis lesions multiplied by an estimate of total body surface area involved. The SPASI is mathematically derived from the PASI. The SPASI and PASI are not identical because of the categorical nature of area estimates used in the PASI. We use existing psoriasis-population data regarding the anatomical distribution of psoriasis lesions to create a simulated patient database. Monte Carlo analysis is then performed to determine the relation between the PASI and SPASI. RESULTS: For a sample population with a mean PASI score of 12.8, the mean SPASI was 14.2. Correlation between the PASI and the SPASI was high (r = 0.90). Bland-Altman analysis showed no consistent bias between the PASI and the SPASI. When attempting to identify simulated patients with a PASI score of 12 (an inclusion criterion for many clinical trials for severe psoriasis), SPASI was 97 percent sensitive and 66 percent specific. DISCUSSION: The SPASI is much less onerous than the PASI, requiring estimation of only four rather than sixteen independent variables. It provides a quick and practical estimate of disease severity similar to the PASI and can be used to communicate that patients have a level of disease severity similar or dissimilar to that of patients studied in clinical trials.

Dermatology↗
PubMed2006

Heartburn severity does not predict disease severity in patients with erosive esophagitis.

BACKGROUND: For patients with gastroesophageal reflux disease (GERD), it is often assumed by treating physicians that the severity of heartburn correlates with the severity of erosive esophagitis (EE). OBJECTIVE: This is a post hoc analysis of data from 5 clinical trials that investigate the relationship between the baseline severity of heartburn and the baseline severity of EE. METHODS: Patients with endoscopically confirmed EE were assessed for heartburn symptoms with a 4-point scale at baseline and during treatment for 8 weeks with various proton pump inhibitors in 5 double-blind trials in which esomeprazole was the common comparator. EE was graded with the Los Angeles (LA) classification system. In these trials, healing and symptom response were evaluated by endoscopy and questionnaire after 4 weeks of treatment. Patients who were not healed were treated for an additional 4 weeks and reevaluated. RESULTS: A total of 11,945 patients with endoscopically confirmed EE participated in the 5 trials, with patients receiving esomeprazole 40 mg (n = 5068), esomeprazole 20 mg (n = 1243), omeprazole 20 mg (n = 3018), or lansoprazole 30 mg (n = 2616). Approximately one quarter of the 11,945 GERD patients in these 5 trials had severe EE (defined as LA grades C or D), regardless of their baseline heartburn severity. CONCLUSION: The severity of GERD symptoms does not correlate well with disease severity. These findings indicate that endoscopy may have value in GERD patients in identifying those with EE, and if empirical therapy is chosen, then longer courses (4-8 weeks) of antisecretory therapy may be necessary to ensure healing of unrecognized esophagitis.

Clinical Trials as Topic↗
PubMed1998

Relation of fibre intake to HbA1c and the prevalence of severe ketoacidosis and severe hypoglycaemia. EURODIAB IDDM Complications Study Group.

The effect of dietary fibre intake on glycaemic control is still controversial. This study analysed the intake of natural dietary fibre in patients with Type I diabetes mellitus enrolled in the EURODIAB IDDM Complications Study to determine any associations with HbA1c levels and with the prevalence of severe ketoacidosis or severe hypoglycaemia. Dietary intake was assessed by a 3-day dietary record. The relation between intake of fibre (total, soluble and insoluble) and HbA1c was examined in 2065 people with Type I diabetes. Associations with severe ketoacidosis (requiring admission to hospital) and severe hypoglycaemia (requiring the help of another person) were analysed in 2687 people with Type I diabetes. Total fibre intake (g/day) was inversely related to HbA1c (p = 0.02), independently of carbohydrate intake, total energy intake and other factors regarding lifestyle and diabetes management. Severe ketoacidosis risk fell significantly with higher fibre intake (p = 0.002), with an adjusted odds ratio of 0.48 (95 % confidence interval 0.27 to 0.84) in the highest quartile ( > or = 23.0 g fibre/day) compared with the lowest quartile ( < or = 13.7 g fibre/day). The occurrence of severe hypoglycaemia was not related to fibre intake. Beneficial effects of fibre on HbA1c and the risk of severe ketoacidosis were particularly pronounced in patients from southern European centres. This study shows that higher fibre intake is independently related to a reduction in HbA1c levels in European people with Type I diabetes. Furthermore, increased fibre intake may reduce the risk of severe ketoacidosis. These beneficial effects were already observed for fibre intake within the range commonly consumed by people with Type I diabetes.

Adolescent↗
PubMed2002

Severe pulmonary hypertension in patients with severe aortic valve stenosis: clinical profile and prognostic implications.

OBJECTIVES: We analyzed the clinical characteristics and outcomes of 47 patients with severe pulmonary hypertension (PHT) and severe aortic valve stenosis (AS) from 1987 to 1999. BACKGROUND: The prognostic implications of severe pulmonary hypertension in patients with severe AS are poorly understood. METHODS: The mean age of patients was 78 years (range 47 to 91 years), and 37 patients (79%) were in New York Heart Association (NYHA) functional class III or IV. Aortic valve replacement (AVR) was performed in 37 patients (79%) and 10 patients (21%) were treated conservatively. RESULTS: In the group that had AVR, there were six perioperative deaths (16%) and nine late deaths, resulting in a total mortality of 32%. In the conservatively treated group, there were eight deaths (80%) on follow-up. Severe PHT was an independent predictor of perioperative mortality. However, perioperative mortality was independent of the severity of left ventricular systolic dysfunction or concomitant coronary artery bypass grafting. Aortic valve replacement was associated with significant improvement in left ventricular ejection fraction, the severity of PHT and NYHA functional class. The difference between long-term survival of the operative survivors and the expected survival from life tables was not statistically significant. CONCLUSIONS: The prognosis for patients with AS and severe PHT treated conservatively without AVR is dismal. Although AVR is associated with higher than usual mortality, the potential benefits outweigh the risk of surgery.

Aged↗
PubMed2003

Performance of the Haemoglobin Colour Scale in diagnosing severe and very severe anaemia.

OBJECTIVE: To assess the accuracy of Haemoglobin Colour Scale (HCS) in identifying severely anaemic [haemoglobin (Hb) <7 g/dl] and very severely anaemic (Hb <5 g/dl) individuals, and to compare the performances of a group of health workers using HCS after training with a standard method. METHOD: The study consisted of two parts. In part 1, the performance of HCS was compared with clinical examination in a hospital population of which more than 450 individuals were severely anaemic and more than 120 very severely anaemic. Part 2 of the study was conducted in eight dispensaries where the performances of 13 health workers using the colour scale were compared with the performances of eight other health workers using clinical signs to estimate Hb. RESULTS: The colour scale was 92% sensitive for both severe anaemia and very severe anaemia and performed better than clinical examination. Health workers who used the colour scale did better in identifying anaemic and severely anaemic individuals, than those who used clinical examination. CONCLUSIONS: The colour scale improves health workers' capacity to identify severely anaemic individuals and could be used as a basis for referral. Although the diagnostic accuracy of the workers using HCS varied widely, in most cases they did significantly better than those who used clinical investigation alone.

Adult↗
PubMed2003

The ENFUMOSA cross-sectional European multicentre study of the clinical phenotype of chronic severe asthma. European Network for Understanding Mechanisms of Severe Asthma.

Since severe asthma is a poorly understood, major health problem, 12 clinical specialist centres in nine European countries formed a European Network For Understanding Mechanisms Of Severe Asthma (ENFUMOSA). In a cross-sectional observational study, a total of 163 subjects with severe asthma were compared with 158 subjects whose asthma was controlled by low doses of inhaled corticosteroids (median dose of beclomethasone equivalents 666 microg). Despite being treated with higher doses of inhaled corticosteroids (median dose 1773 microg) and for a third of the severe asthmatics also being treated with regular, oral-steroid therapy (median daily dose 19 mg), the subjects with severe asthma met the inclusion criteria. The criteria required subjects to have undergone at least one asthma exacerbation in the past year requiring oral steroid treatment. Females dominated the severe asthma group (female/male ratio 4.4:1 versus 1.6:1 in the controlled asthmatics), and compared with controlled asthmatics, they had a predominantly neutrophilic inflammation (sputum neutrophils, 36 versus 28%) and evidence of ongoing mediator release but less atopy. From these findings and other physiological and clinical data reported in this paper, it is suggested that severe asthma might be a different form of asthma rather than an increase in asthma symptoms. The findings prompt for longitudinal studies and interventions to define the mechanisms in severe asthma.

Administration, Inhalation↗
PubMed1997

Factors relating to the severity of symptoms at 5 yrs in children with severe wheeze in the first 2 yrs of life.

Wheezing in early childhood covers a wide spectrum of morbidity. Since little is known about the factors determining either the pattern or the severity of this range of symptoms, 51 children, admitted to hospital with acute wheeze in the first 2 yrs of life, were monitored prospectively between the ages of 4.5-5.5 yrs. Our hypothesis was that the predictors of severe episodes and of interval symptoms in 5 year olds would differ. Symptom diaries were kept, from which the symptom pattern and severity was assessed. The frequency and severity of acute episodes were analysed separately from day-to-day (interval) symptoms. A physiological assessment was made at 5 yrs. During the 12 month study period, 11 children were symptom-free, 15 were reported to wheeze only in response to viral infections, and 25 wheezed from multiple triggers. Bronchial responsiveness was significantly increased in those with a family history of asthma but was unrelated to any index of atopy. In a multiple logistic regression analysis, a family history of asthma and a personal history of allergy (but not results of skin-prick testing or serum immunoglobulin E (IgE) significantly predicted both attack severity and interval symptoms. An additive effect of two factors (atopy plus a family history of asthma or bronchial responsiveness) on symptom severity was suggested, without any evidence of an interaction. It is concluded that in this population of 5 year olds, with an early history of severe wheezing, familial bronchial responsiveness and atopy of operated independently to determine both interval symptoms and attack severity.

Acute Disease↗
PubMed2005

Lack of evidence for qualitative treatment by disease severity interactions in clinical studies of severe sepsis.

INTRODUCTION: The design of clinical trials of interventions aimed at reducing mortality in patients with severe sepsis assumes that the relative treatment effect of the intervention is independent of the patients' risk for death. We reviewed published data from phase III clinical studies of severe sepsis to determine whether a relationship exists between risk for death and the relative benefit of the investigational agent. Such an interaction might warrant a change in the assumptions that underlie current trial designs. METHODS: We conducted a systematic review of published phase III, randomized, placebo-controlled trials in adult patients with sepsis, severe sepsis, or septic shock up to November 2004. All studies enrolled patients with known or suspected infection, evidence of a systemic response to the infection, and one or more organ dysfunctions resulting from the systemic response. RESULTS: Twenty-two publications, investigating 17 molecular entities, fulfilled criteria for phase III or equivalent studies aimed at reducing mortality in adult patients with severe sepsis or septic shock. Three studies achieved the prospectively defined primary end-point of a statistically significant reduction in 28-day all-cause mortality. The control group mortality rates for these studies were 31%, 43% and 61%, indicating that the beneficial effects of adjunct therapies could be demonstrated over a wide range of illness severity. Analysis of subgroup data from failed studies provided no evidence that the efficacy of the therapeutics being investigated varied by baseline placebo mortality rates. Among all studies, interventions with anticoagulant activity or anti-inflammatory activity did not appear to be harmful in patients with evidence of less coagulopathy or less inflammation. CONCLUSION: Our review of published clinical data does not support the hypothesis that mortality risk of the population studied alters the relative treatment effect associated with anti-inflammatory or other agents used to treat severe sepsis. Clinical studies in severe sepsis should continue to enroll patients over a wide range of disease severity, as long as patients enrolled have evidence of sepsis-induced organ dysfunction(s), patients are at an appreciable risk for death (e.g. as evidenced by admission to an intensive care unit), and the potential for benefit outweighs the potential for harm.

APACHE↗
PubMedDate not supplied

[Outcome and prognosis of surgical treatment in patients with severe aortic stenosis with respect to the duration and severity of associated aortic regurgitation].

INTRODUCTION: It is not clear whether associated aortic regurgitation (AR) should be regarded as a risk factor in patients undergoing surgery for severe aortic stenosis (AS). Some authors have suggested that morbidity and mortality are increased in these patients as compared to patients operated for pure AS, whereas others have found no difference of the outcome and prognosis between these groups. OBJECTIVE: This study made an attempt to compare the outcome and prognosis following the surgical intervention in patients with severe AS and associated AR and those operated for pure AS, as well as to determine predictive value of clinical, functional and echocardiographic data for the outcome of surgery. METHODS: Study population consisted of 122 consecutive patients operated at Dedinje Cardiovascular Institute during 1999 due to severe AS, defined as mean gradient over aortic valve >30 mmHg. The patients were divided into AS group (63 patients with AS without AR or with mild AR) and AS+AR group (59 patients with AS and moderate, severe or very severe AR). The patients were subjected to control clinical, functional and echocardiographic examinations 12 and 18 months following the surgery. RESULTS AND DISCUSSION: Preoperatively, the patients in AS group were older and had coronary artery disease more frequently, whereas patients in AS+AR group had higher left ventricular volumes and mass. Preoperative NYHA class, ejection fraction, mean gradient over aortic valve, type and size of the implanted mechanical prosthesis, and the incidence of associated coronary artery bypass surgery were similar between the groups. Similarly, the operative mortality was similar in AS and AS+AR groups (1.6% vs 8.5%, respectively, p=0.11). Twelve months postoperatively, there were no difference of average NYHA class and NYHA class III/IV between the groups. The patients in AS+AR group were unable to walk >300 meters on 6 minute walk test more frequently than those in AS group (64% vs. 36%, respectively; p=0.043). Eighteen months postoperatively, NYHA class III/IV was found more frequently in AS+AR than in AS group (26% vs. 8%, respectively; p=0.0343). In patients with associated AR, there was no difference of NYHA class with respect to the severity of AR (p=0.815). Multivariate analysis found the association of more than mild AR as an independent predictor of poor functional capacity, irrespective of its severity. CONCLUSION: Patients with severe AS and associated AR have poorer postoperative functional capacity as compared to patients operated for pure AS.

Aortic Valve Insufficiency↗
PubMed1992

The severity of herpes simplex viral keratitis in mice does not reflect the severity of disease in humans.

Four herpes simplex type 1 virus (HSV) isolates were selected from patients with mild ocular disease and four from patients with severe ocular disease on the basis of the number of epithelial recurrences, presence or absence of stromal disease, visual acuity, and the need for corneal transplantation. The scarified right corneas of 20 BALB/c mice were inoculated with each low-passage HSV isolate (1.0 x 10(7) plaque-forming units/ml) and examined three times per week for 2 weeks for the presence and severity of epithelial and stromal disease. The eight individual virus isolates differed with respect to the incidence of dendritic disease (P less than 0.001), the severity of dendritic disease (P less than 0.001), the incidence of stromal disease (P = 0.002), and the severity of stromal disease (P = 0.001) they produced in the mouse. The severity of disease was compared for the two groups of viruses: (1) those that had caused mild disease in their human hosts and (2) those that had caused severe disease. There were no statistically significant differences in the severity or incidence (44 versus 43 animals, respectively) of dendritic disease or stromal disease (27 of 80 animals in each group) between the two groups. These data suggest that the naive BALB/c mouse model of acute HSV keratitis after topical ocular inoculation does not reflect clinically significant differences in the severity of human HSV keratitis that might be caused by variations in the virus genome.

Animals↗
PubMedDate not supplied

Status asthmaticus, severe acute asthma or severe exacerbation of asthma.

"Status Asthmaticus" is an old term which has been defined in many different ways. Two distinctive features are usually used to identify "Status Asthmaticus": severity and lack of response to bronchodilators. However, the latter condition is not always observed and thus the term "Status Asthmaticus" basically implies severity. "Severe acute asthma" is a new term which has replaced "Status Asthmaticus". Nevertheless, a severe attack of asthma may occur suddenly or can take place after days or weeks of a progressive deterioration. A "Status Asthmaticus" can be "acute" or "subacute" according to the rate of deterioration; therefore the term "Severe acute asthma" is misleading. Since the term "Status Asthmaticus" essentially implies severity, severe attacks would be better described as "Severe exacerbation of asthma" (SEA). Classification of the SEA into two types (acute and subacute), could help to reveal the etiology of the attack and might also be relevant to the management of the patient. For instance an acute SEA can be seen in brittle asthma and in patients with aspirin intolerance. On the other hand, patients with the subacute form are refractory to bronchodilators and must be treated with corticosteroids.

Acute Disease↗
PubMed1996

Correlation between quantitative severity of stress thallium-201 myocardial perfusion defect and severity of coronary stenosis.

The correlation between the quantitative myocardial perfusion defect severity of stress 201Tl single-photon emission computed tomography and the severity of coronary stenosis was investigated in 28 patients with angina pectoris. Among the 28 patients, four had normal or nearly normal coronary angiograms, seven had one-vessel disease, six had two-vessel disease and 11 had three-vessel disease. Seven patients had prior myocardial infarctions and two had collateral flows to the diseased vessels. The quantitative 201Tl defect severity score was obtained by summing the standard deviations of each pixel in which the counts fell > 2.5 SD below the mean normal counts. The severity of coronary stenosis was expressed as the Gensini score. The quantitative 201Tl defect severity score correlated significantly with the Gensini score. In patients without prior myocardial infarction or collateral flow, a more significant correlation between the quantitative 201Tl defect severity score and the Gensini score was found. Quantitative analysis of stress 201Tl defect severity provides a useful, noninvasive assessment of the functional severity of coronary stenosis compared with coronary angiography.

Adult↗
PubMed2005

Molecular signature of clinical severity in recovering patients with severe acute respiratory syndrome coronavirus (SARS-CoV).

BACKGROUND: Severe acute respiratory syndrome (SARS), a recent epidemic human disease, is caused by a novel coronavirus (SARS-CoV). First reported in Asia, SARS quickly spread worldwide through international travelling. As of July 2003, the World Health Organization reported a total of 8,437 people afflicted with SARS with a 9.6% mortality rate. Although immunopathological damages may account for the severity of respiratory distress, little is known about how the genome-wide gene expression of the host changes under the attack of SARS-CoV. RESULTS: Based on changes in gene expression of peripheral blood, we identified 52 signature genes that accurately discriminated acute SARS patients from non-SARS controls. While a general suppression of gene expression predominated in SARS-infected blood, several genes including those involved in innate immunity, such as defensins and eosinophil-derived neurotoxin, were upregulated. Instead of employing clustering methods, we ranked the severity of recovering SARS patients by generalized associate plots (GAP) according to the expression profiles of 52 signature genes. Through this method, we discovered a smooth transition pattern of severity from normal controls to acute SARS patients. The rank of SARS severity was significantly correlated with the recovery period (in days) and with the clinical pulmonary infection score. CONCLUSION: The use of the GAP approach has proved useful in analyzing the complexity and continuity of biological systems. The severity rank derived from the global expression profile of significantly regulated genes in patients may be useful for further elucidating the pathophysiology of their disease.

Algorithms↗
PubMed1989

Using severity information for quality assessment: a review of three cases by five severity measures.

Five severity measurement systems--APACHE II, Computerized Severity Index, Disease Staging (both Q-Scale and clinical criteria version), MedisGroups, and Patient Management Categories--were applied to three clinical cases. Severity results and recommendations for quality review were then compared and contrasted. Systems that define severity based on resource need produce different impressions than those that define severity in more clinical terms. In-depth quality review is generally suggested when severity scores later in the hospital stay are higher than at admission. Recommendations for review may be automatic or tied to other factors. Some systems use normative data, based on observed severity patterns and patient outcomes, to guide decisions about quality reviews.

Adolescent↗
PubMed2004

Severe cutaneous papillomavirus disease after haemopoietic stem-cell transplantation in patients with severe combined immune deficiency caused by common gammac cytokine receptor subunit or JAK-3 deficiency.

Haemopoietic stem-cell transplantation is a life-saving treatment for severe combined immune deficiency. However, there has been little long-term follow-up of this treatment. There is evidence for the persistance of partial immunodeficiency associated with significant infections, including severe human papillomavirus (HPV) disease. We did a retrospective analysis of severe HPV disease in a group of 41 patients with severe combined immune deficiency from one centre who were alive 10 years or longer after haemopoietic stem-cell transplantation. Nine of the 41 patients had extensive chronic HPV disease limited to the skin, with a median onset at 8 years after transplantation. Four had lesions typical of epidermodysplasia verruciformis, a rare genodermatosis. Transplant characteristics, immune status, and chimerism of these nine patients did not differ significantly from those of the other patients. The nine patients with HPV disease had severe combined immune deficiency associated with either common gammac receptor cytokine subunit or Janus kinase-3 (JAK-3) deficiency. By contrast, patients with other forms of severe combined immune deficiency did not have any signs of HPV disease. That genetic causes are the only predisposing factor to be identified for severe combined immune deficiency, suggests that natural-killer cells or gammac/JAK-3-dependent signalling in keratinocytes could have a role in anti-HPV immunity.

Child↗
PubMed2000

Initial severity of metabolic acidosis predicts the development of acute lung injury in severely traumatized patients.

OBJECTIVES: First, to determine whether the severity of shock, as measured by systemic hypotension and metabolic acidosis, is significantly associated with a higher risk of acute lung injury in patients with severe trauma. Second, to determine whether the volumes of blood and crystalloid solutions administered in the early posttrauma period are independent risk factors for acute lung injury in severely traumatized patients. DESIGN: Prospective observational study. SETTING: Level I urban trauma center in a university hospital. PATIENTS: A total of 102 severely injured, mechanically ventilated trauma patients with an Injury Severity Score > or =16 and aged between 18 and 75 yrs. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Initial clinical and laboratory data were collected in the emergency department, and on a daily basis thereafter during the patient's intensive care unit stay. Of the 102 severely injured patients enrolled, 42 developed acute lung injury (41%) and 60 did not (59%). A total of 93% of the trauma patients who developed acute lung injury during the 17-month study period were included in the study. Initial base deficit was significantly lower in patients who developed acute lung injury than in those who did not (-8.8+/-4.5 vs. -5.6+/-5.1, p<.01). The difference in systolic blood pressure between the two groups was not significant. CONCLUSIONS: In this group of severely injured trauma patients, the degree of metabolic acidosis at the time of admission identified those patients with the highest probability of developing acute lung injury. In addition, the volume of crystalloid solution administered during the first 24 hrs was significantly greater in patients who later developed acute lung injury. Finally, there was a significantly higher morbidity in patients who developed acute lung injury, whereas mortality did not differ between the two groups.

APACHE↗
PubMed1996

Disease severity measures in a population of psoriasis patients: the symptoms of psoriasis correlate with self-administered psoriasis area severity index scores.

Because of the difficulty and expense of objectively measuring psoriasis severity, very little information exists on the severity of psoriasis in populations. We determined severity in a psoriasis patient population using the validated self-administered psoriasis area and severity index (SAPASI). This population consisted of 578 university dermatology clinic psoriasis patients, and data were analyzed from 317 (55%) questionnaire respondents. The majority of our sample was women (57%), and non-Caucasians represented a larger portion (8 %) in our sample compared with some previous studies. In our population, the reported frequencies of skin and joint symptoms were as follows: pruritus (95 %), skin burning (81 %), joint pain (69%), arthritis (51%), and psoriatic arthritis (20%). The SAPASI was significantly associated with severity of pruritus, burning, joint pain, and psoriatic arthritis. There was a significant negative correlation between the number of treatments employed and the SAPASI. This study provides results of a detailed measurement of the severity of psoriasis in a psoriasis patient population and relates this severity to population characteristics.

Adolescent↗
PubMed2005

The psoriasis area and severity index is the adequate criterion to define severity in chronic plaque-type psoriasis.

BACKGROUND: Chronic plaque-type psoriasis is a major dermatosis, but a significant question is still unanswered: What defines severity in chronic plaque-type psoriasis? While objective assessments like the Psoriasis Area and Severity Index (PASI) have frequently been used in clinical trials, quality of life (QOL) questionnaires are currently becoming more and more popular. OBJECTIVE: This article summarizes the most important objective and subjective measurements of severity in psoriasis. For every dermatologist it is critically important to distinguish between severe psoriasis and psoriasis that severely affects QOL. Even if the PASI also has disadvantages, it is the most adequate instrument available to evaluate severity in plaque-type psoriasis. RESULT: We provide reasons why PASI >12 defines severe, PASI 7-12 moderate and PASI <7 mild chronic plaque-type psoriasis.

Humans↗