Rethinking the Psoriasis Area and Severity Index: the impact of area should be increased

Jacobson, Christine C.; Kimball, Alexa B.

doi:10.1111/j.1365-2133.2004.06035.x

Cited by 80 publications

(82 citation statements)

References 24 publications

(29 reference statements)

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“…22 Body surface area (BSA) and the psoriatic area severity index (PASI) were used to assess disease activity. BSA 23 and PASI 24 above 10 were considered increased. The soluble cytokines IL-6, IL-12p70, TNF-α, IL-10, IL-1β and IL-8 were simultaneously measured by flow cytometry using Cytometric Bead Array (CBA) Human Inflammatory Cytokine Kit (BD Biosciences).…”

Section: Methodsmentioning

confidence: 99%

Subclinical atherogenesis in patients with mild psoriasis: A role for IL-6?

Lise

Baptista

Petersen

et al. 2017

Rev. Assoc. Med. Bras.

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Summary Introduction: A link of psoriasis with subclinical atherosclerosis has been postulated and cytokine network might intermediate this association. Few data are available in patients with mild psoriasis. We evaluated carotid intima-media thickness (cIMT) in drug-free psoriatic individuals and controls. In parallel, we searched for associations of cIMT with disease activity indexes and serum interleukins (IL) in psoriatic patients. Method: An experienced radiologist performed the cIMT analyses. Cytokine concentrations were assessed by flow cytometry. Disease activity was evaluated based on psoriasis area and severity index (PASI) as well as body surface area (BSA). Results: Sixty-five (65) patients and 64 controls were studied. Mean age of patients (50.9 years) did not differ from controls (p=0.362). A low PASI and BSA (< 10) prevailed (69.2% and 56.9%, respectively). Median levels of IL-12p70, TNF-α, IL-1β and IL-10 were significantly lower in cases than in controls (adjusted p<0.05), while IL-6 and IL-8 medians did not differ between groups (adjusted p>0.05). Smoking habit and diabetes mellitus predominated in cases (p=0.002). An altered cIMT (≥ 0.9 mm) was more frequent in cases than in controls (23.8% versus 8.5%, adjusted p=0.045). Mean cIMT was higher in cases with a borderline significance (p=0.057). cIMT scores did not correlate to PASI (rs=0.066; p=0.250) or BSA (rs=0.175; p=0.185), but did correlate significantly with serum IL-6 (rs=0.26; p=0.005). Conclusion: Subclinical atherosclerosis was more frequent in patients with mild psoriasis than controls. cIMT in psoriatic individuals correlated with serum IL-6, pointing to an eventual proatherogenic role of IL-6 in these patients. Newer studies should clarify the connection of atherogenesis with cytokines in psoriasis.

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Section: Methodsmentioning

confidence: 99%

Subclinical atherogenesis in patients with mild psoriasis: A role for IL-6?

Lise

Baptista

Petersen

et al. 2017

Rev. Assoc. Med. Bras.

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“…Criticisms of the PASI include decreased interrater agreement for high scores and poor sensitivity for treatment that decreases erythema, scaling, and infiltration of lesions when there is no modification of BSA affected 21 . PASI underestimates treatment-associated improvements compared with measures of patient's self-assessment 22 . Other limitations noted for the PASI are that lesion thickness is not carefully defined and …”

Section: Discussionmentioning

confidence: 99%

Application and Modifications of Minimal Disease Activity Measures for Patients with Psoriatic Arthritis Treated with Adalimumab: Subanalyses of ADEPT

et al. 2013

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Objective.This posthoc analysis evaluated the percentage of patients with psoriatic arthritis (PsA) who achieved minimal disease activity (MDA) and compared the results with a modified MDA substituting the physician global assessment (PGA) for the Psoriasis Activity and Severity Index (PASI) using data from the ADalimumab Effectiveness in Psoriatic Arthritis Trial (ADEPT; NCT00646386).Methods.Patients with active PsA were randomized to receive adalimumab 40 mg or placebo every other week for 24 weeks. MDA was defined as achieving ≥ 5 of the following criteria: tender joint count ≤ 1; swollen joint count ≤ 1; PASI ≤ 1 or body surface area ≤ 3%; patient pain score ≤ 15 [1–100 mm visual analog scale (VAS)]; patient global assessment (PGA) of disease activity ≤ 20 (1–100 mm VAS); Health Assessment Questionnaire ≤ 0.5; and tender entheseal points ≤ 1 (only heels assessed). For modification of the MDA, PASI ≤ 1 was substituted with PGA “Clear” as MDAPGA1 and PGA “Clear” or “Almost clear” as MDAPGA2.Results.Sixty-seven patients were treated with adalimumab and 69 with placebo. At Week 24, MDA, MDAPGA1, and MDAPGA2 were achieved by 39%, 37%, and 39%, respectively, of patients treated with adalimumab versus 7%, 5%, and 8% of patients on placebo (p < 0.001). Kappa coefficients indicated good agreement between PASI and PGA at Week 24.Conclusion.ADEPT results indicated that significantly more patients treated with adalimumab achieved MDA by Week 24 compared with placebo. Modification of the MDA by replacing PASI ≤ 1 with PGA assessments did not alter the results, which may improve feasibility of practical use of the index.

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“…This index analyzes the four regions of the body (head, trunk, upper and lower limbs) in relation to erythema, induration (thickness), desquamation (scaling) of the plaques, and body surface area (BSA) affected. 3 Scores from 0 to 4 are attributed to erythema, induration and scaling, based on their intensity (0-absent, 1-mild, 2-moderate, 3-intense, 4-severe). The BSA affected is expressed in percentage (1 to 100%), with corresponding scores that range from 1 to 6.…”

Section: Introductionmentioning

confidence: 99%

Importância da variação do PASI realizado por diversos observadores

Faria

Aarão

Jimenez

et al. 2010

An. Bras. Dermatol.

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BACKGROUND: Developed in 1978, the PASI (Psoriasis Area and Severity Index) is a method to rate psoriasis severity. Since then, it has been criticized for being extremely long, complex and for yielding significantly divergent interpretations. OBJECTIVE: To determine the PASI inter-rater reliability among three independent evaluators examining the same patients. METHODS: Cross-sectional study conducted in 2007 at a psoriasis treatment center, where 20 patients were selected. The patients were evaluated by three postgraduate students of Dermatology who independently determined the PASI of each patient. The inter-rater reliability coefficient was determined by employing intraclass correlation coefficients (ICC)

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Rethinking the Psoriasis Area and Severity Index: the impact of area should be increased

Cited by 80 publications

References 24 publications

Subclinical atherogenesis in patients with mild psoriasis: A role for IL-6?

Subclinical atherogenesis in patients with mild psoriasis: A role for IL-6?

Application and Modifications of Minimal Disease Activity Measures for Patients with Psoriatic Arthritis Treated with Adalimumab: Subanalyses of ADEPT

Importância da variação do PASI realizado por diversos observadores

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