New method of determining psoriasis severity announced

The International Psoriasis Council (IPC) has developed a new, more simple method of classify psoriasis severity to aid physicians in determining the right course of treatment.

Previously diagnosis of severity and subsequent treatment was centred on classifying patients as either having mild, moderate or severe psoriasis, depending on the percentage of body surface area (BSA) where the condition was active  or by using the Psoriasis Area Severity Index (PASI), which measures the body area of the disease and intensity of scaling, redness and induration. 

However, it was felt that these approaches did not take into account the impact of psoriasis on particular areas of the body such as the face, nails, scalp, hands/feet and genitals and did not consider how patients had responded to topical therapies. This meant that people with lower severity forms of the condition were often denied access to critical systemic treatments to control symptoms.

The IPC method turns this on its head by making it a treatment-first approach that calls for classifying patients as candidates either for topical therapy or systemic therapy. To qualify for systemic therapy, patients must meet one or more of the following criteria:

• Psoriasis lesions on 10% or more of their body surface
• Psoriasis lesions on sensitive areas of the body (i.e., hands/feet, face, genitals, scalp)
• Topical therapy failed to control symptoms

“So far patients with less involvement than PASI 10 or BSA 10 were not eligible for a treatment with a biologic in many countries, although they may suffer quite a bit from their disease. This new approach to classifying psoriasis severity furthers IPC’s work to help improve the health of psoriasis patients around the world,” said Peter van de Kerkhof, MD, PhD, chief medical officer of IPC. 

Dr Bruce Strober, assistant clinical professor at Yale University and secretary-treasurer of the IPC Board of Directors, added, “There’s a lot of unnecessary suffering among psoriasis patients due to ‘under-classifying’ the severity of the disease. This new approach to assess psoriasis severity developed by an IPC-led Delphi exercise aims to help providers everywhere start their patients on the appropriate treatment, and sooner.”