PASI Score - An Overview

Introduction:

Psoriasis is a skin disease that causes raised and scaly patches on one's skin. Psoriasis is a long-term disease without a cure, but many treatment options are available to manage the symptoms. The proper treatment approach depends on the psoriasis severity and type. Classifying psoriasis can be complex and subjective. However, dermatologists use several tools to categorize psoriasis according to agreed-upon standards. The psoriasis area and the severity index score aim to measure psoriasis' severity objectively. It is often used in clinical trials to determine whether or not a new psoriasis treatment is working well. One PASI score is based on how much the body is affected by psoriasis, how the scales appear, and other factors. One can learn the math formula behind that PASI score system, having a basic understanding of the score that could be helpful for the treatment. PASI score helps doctors in prescribing treatment for individuals. When the score does not decrease in response, a doctor can prescribe medication that may be more effectively used. Since psoriasis is a skin disease, patients feel lonely when they are isolated from society due to the appearance of the skin.

What Is PASI Score?

A PASI score is a tool dermatologists use to measure the disease severity and extent of psoriasis. PASI is an acronym for psoriasis area and severity index. Completing a PASI score takes a few minutes and experience to calculate accurately. This tool allows them to monitor the condition's progression and evaluate the effectiveness of the treatment.

A PASI score ranges from zero to 72. However, while 72 is technically the highest option, scores over 40 are rare. The scoring involves rating the symptoms of psoriasis from none of the symptoms to severe and estimating the percentage of the body that affects it. For example, one PASI score indicates the following:

• Zero to Five: None to mild psoriasis.

• Six to Ten: Moderate psoriasis.

• Eleven or Above: Severe psoriasis.

How Is PASI Score Calculated?

The PASI score result is calculated through a complicated math formula that uses information the dermatologist acquires through a physical examination of one's psoriasis. Then, the doctor will do the calculations, likely with the help of a computer.

Area Calculation: A doctor will assess one's entire body for visible psoriasis symptoms to get an area calculation of one's symptoms. Four different regions of the body will be scored individually. The following are the regions:

• Head.

• Upper extremities (arms and hands).

• Trunk (torso).

• Lower extremities (legs and feet).

One doctor will look for psoriasis scales on each area and give each area a score of zero to six.

• 0 - No involvement.

• 1 - One to nine percent of the area has psoriasis present.

• 2 - Ten to 29 percent of the area has psoriasis present.

• 3 - 30 to 49 percent of the area has psoriasis present.

• 4 - 50 to 69 percent of the area has psoriasis present.

• 5 - 70 to 89 percent of the area has psoriasis present.

• 6 - 90 to 100 percent of the area has psoriasis present.

For example, if 25 percent of the patient's arms and hands are covered in psoriasis scales, the doctor would mark one's condition as "2" in the upper extremities region. If one does not have any psoriasis on the legs or feet, one's condition would be scored as "0" in the lower extremities.

Intensity Calculation: The patient's body area has psoriasis involvement, and symptom severity is also ranked from zero to four. This symptom severity score of each area is based on the following:

• Redness.

• Swelling.

• Thickness.

• The thickness of one's psoriasis scale.

While the PASI score is used as objectively as possible, subjective parts are still centered on the doctor's opinions and evaluation of the patient's psoriasis. Therefore, it is important to get evaluated by an expert, usually a dermatologist. Skin experts will know what to look for and have context for the range of psoriasis severity of psoriatic lesions.

Can PASI Score Change?

Yes, the PASI score can change over time. Successful treatments can bring down one's score. For example, if a patient reaches a milestone called "PASI 75," that is not a specific score scale but is a benchmark for treatment success.

What Are the Treatment Options for Psoriasis?

First-line treatment for psoriasis will be based on the patient's PASI score. The doctor will often prescribe topical treatments and lifestyle changes for mild to moderate psoriasis. Doctors may also recommend oral and injectable medications and light therapies for people with severe psoriasis that do not respond to conservative treatment approaches. Standard treatment options for psoriasis include:

Topical medications and ointments, such as:

• Corticosteroids.

• Vitamin - D-based creams.

• Retinoids.

Oral medications, such as:

• Acitretin (Soriatane).

• Cyclosporine (Gengraf, Neoral, or Sandimmune).

• Apremilast (Otezla).

• Biological medications (immune system modifiers).

• Phytotherapies.

• Lifestyle changes, including:

• Eating a balanced diet.

• Reducing stress.

• Quitting smoking.

If one is concerned about psoriasis symptoms or wants to try a different treatment approach, one should discuss it with their doctor. Even though the PASI score can help identify what type of treatment might be the best first option, it is essential to remember that everyone's body is different. No one responds in the same way to different medications or therapies. It can take some time to find which makes it best for one. In case, one does not have a psoriasis diagnosis but experiences anything troubling or skin changes, including scaling or redness or itching is seen in severity of psoriatic lesions and the patient's response to the treatment.

Conclusion:

Skin conditions like psoriasis can impact one's quality of life, from lowering the patient's confidence to causing uncomfortable physical symptoms lasting longer.The PASI score is one metric dermatologists use to understand the severity of psoriasis symptoms. In addition, it may help patients better understand their psoriasis, which helps to decide which treatment options are the best to try and see the effectiveness of the treatment's results can be seen in the patients affected by psoriasis. After treating psoriasis while curing the depression caused by psoriasis is also reduced psychologically.