The Salford Psoriasis Index: an holistic measure of psoriasis severity

Abstract

We have developed, tested and validated a new scoring system for psoriasis: the Salford Psoriasis Index (SPI). The SPI incorporates the current clinical extent of psoriasis based on the Psoriasis Area and Severity Index (PASI), a score indicating psychosocial disability, and past severity based on treatment history. The resultant three-figure SPI (signs, psychosocial disability, interventions) is a similar paradigm to the TNM (tumour, nodes, metastasis) classification used for cancer staging. The first figure transforms the PASI into a number from 0 to 10 reflecting extent of psoriasis. The second assesses the psychosocial impact of psoriasis on each patient using a 0-10 visual analogue scale. The third figure reflects historical severity of disease as judged by the need for systemic treatment, admission to hospital and number of episodes of erythroderma. The SPI was prospectively employed in assessing 150 consecutive patients with psoriasis. Furthermore, in a separate cohort of 100 patients we tested the Psychosocial Impact Score against a recognized self-report psoriasis-specific measure, the Psoriasis Disability Index. There was a strong correlation between the two (r = 0.59, P < 0.001). However, the Psychosocial Impact Score correlated poorly with clinical extent scores such as the PASI (r = 0.28, P < 0.05) and the Self-administered PASI in 72 patients tested (r = 0.19, P = 0.1). There was a high correlation between all six observers in 20 patients for both PASI (r = 0.71; 95% confidence interval, CI 0.51-0.86) and the Extent Score (r = 0.70; 95% CI 0. 56-0.89). We believe that the SPI will be more relevant to real-life categorization of psoriasis severity in that it takes an holistic approach based not only on physician assessment but also psychological disability and treatment resistance.

Outcome Measures in Psoriatic Disease

“…It was found to be reliable compared to objective measures of psoriasis activity, and is highly reproducible [12][13][14]. It can be reliably performed by dermatologists and clinicians from other specialties after short training [15,16]. The selfadministered version of PASI (SAPSI) that is performed by psoriasis patients correlates well with PASI [17].…”

Effect of Diet and Exercise on Plaque Psoriasis in Children

“…Evaluation of psoriasis in pre-treatment groups show increased severity of psoriasis in both groups and increasing the pasi score in those children showed that they have high severity of the disease [3].…”

“…Relation between food and psoriasis and metabolic syndrome was investigated proving our idea about food and an auto immune disease like psoriasis [21][22][23][24][25][26][27][28].…”

Psoriasis: Epidemiology, Clinical and Histological Features, Triggering Factors, Assessment of Severity and Psychosocial Aspects

“…There are even more specific measures for psoriasis. For instance, scores that include psychological impact along with the severity of the skin lesions are the Salford Psoriasis Index and the Psoriasis Disability Index (Kirby, Fortune et al 2000). A psoriasis-specific study of QOL, the PSORIQOL, is a recently introduced 25-item instrument (McKenna, Cook et al 2003).…”