Psoriasis classification: Difference between revisions
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* [[Fever|High grade fever]] | * [[Fever|High grade fever]] | ||
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=== Subphenotypes === | === Subphenotypes === | ||
Several further subphenotypes have been named according to: | Several further subphenotypes have been named according to: | ||
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* Onset (early vs. late) | * Onset (early vs. late) | ||
* Disease activity (active vs. stable) | * Disease activity (active vs. stable) | ||
===Classification according to severity=== | ===Classification according to severity=== | ||
[[Image:Psoriasis severity.jpg|thumb|150px|left|Pie chart showing the distribution of severity among people with psoriasis.]] | [[Image:Psoriasis severity.jpg|thumb|150px|left|Pie chart showing the distribution of severity among people with psoriasis.]] | ||
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* Moderate (affecting 3-10% of the body) | * Moderate (affecting 3-10% of the body) | ||
* Severe | * Severe | ||
=== Degree of severity === | === Degree of severity === | ||
The degree of severity is generally based on the following factors: | The degree of severity is generally based on the following factors: | ||
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The Psoriasis Area Severity Index (PASI) is the most widely used measurement tool for psoriasis. PASI combines the assessment of the severity of lesions and the area affected into a single score in the range 0 (no disease) to 72 (maximal disease).<ref>{{cite web |url=http://www.skinandaging.com/article/5394 |title=Psoriasis Update -Skin & Aging |accessdate=2007-07-28 |format= |work=}}</ref> | The Psoriasis Area Severity Index (PASI) is the most widely used measurement tool for psoriasis. PASI combines the assessment of the severity of lesions and the area affected into a single score in the range 0 (no disease) to 72 (maximal disease).<ref>{{cite web |url=http://www.skinandaging.com/article/5394 |title=Psoriasis Update -Skin & Aging |accessdate=2007-07-28 |format= |work=}}</ref> | ||
The PASI can be too unwieldy to use outside of trials, which has led to attempts to simplify the index for clinical use.<ref name="pmid15530297">{{cite journal |author=Louden BA, Pearce DJ, Lang W, Feldman SR |title=A Simplified Psoriasis Area Severity Index (SPASI) for rating psoriasis severity in clinic patients |journal=Dermatol. Online J. |volume=10 |issue=2 |pages=7 |year=2004 |pmid=15530297 |doi=}}</ref> | The PASI can be too unwieldy to use outside of trials, which has led to attempts to simplify the index for clinical use.<ref name="pmid15530297">{{cite journal |author=Louden BA, Pearce DJ, Lang W, Feldman SR |title=A Simplified Psoriasis Area Severity Index (SPASI) for rating psoriasis severity in clinic patients |journal=Dermatol. Online J. |volume=10 |issue=2 |pages=7 |year=2004 |pmid=15530297 |doi=}}</ref> | ||
=== Other types of psoriasis === | === Other types of psoriasis === | ||
*[[Ventral|Flexural]] psoriasis (inverse psoriasis) appears as smooth [[inflamed]] patches of [[skin]]. It occurs in [[skin fold]]s, particularly around the [[genitals]] (between the [[thigh]] and [[groin]]), axillae, under an overweight [[stomach]] ([[pannus]]), and under the [[breasts]] ([[inframammary fold]]). It is aggravated by [[friction]] and [[sweat]], and is vulnerable to [[fungal]] [[infections]]. | *[[Ventral|Flexural]] psoriasis (inverse psoriasis) appears as smooth [[inflamed]] patches of [[skin]]. It occurs in [[skin fold]]s, particularly around the [[genitals]] (between the [[thigh]] and [[groin]]), axillae, under an overweight [[stomach]] ([[pannus]]), and under the [[breasts]] ([[inframammary fold]]). It is aggravated by [[friction]] and [[sweat]], and is vulnerable to [[fungal]] [[infections]]. | ||
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*Seborrheic-like psoriasis | *Seborrheic-like psoriasis | ||
*Pustular psoriasis | *Pustular psoriasis | ||
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Image:Psoriasis.jpg|Photograph of an arm covered with plaque psoriasis. | |||
Image:Psoriasis nail pitting.jpg|Psoriasis nail pitting | |||
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</div> | |||
Revision as of 18:15, 26 July 2017
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Psoriasis Microchapters |
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Diagnosis |
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Treatment |
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Case Studies |
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Psoriasis classification On the Web |
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American Roentgen Ray Society Images of Psoriasis classification |
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Risk calculators and risk factors for Psoriasis classification |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Syed Hassan A. Kazmi BSc, MD [2]
Overview
Psoriasis can be classified according to clinical appearance, morphology and localization. According to International Psoriasis Council, psoriasis may be classified into four subtypes: plaque-type psoriasis, guttate psoriasis, generalized pustular psoriasis (GPP), erythroderma. Several further subphenotypes have been named according to distribution (localized vs. widespread), anatomical localization (flexural - also called inverse, scalp, palms/soles/nail), size (large vs. small) and thickness (thick vs. thin) of plaques, onset (early vs. late), and disease activity (active vs. stable).
Classification
Classification based on clinical apperance, morphology and localization
- The International Psoriasis Council classifies psoriasis into four main forms, according to clinical appearance, morphology and localization:
- Plaque-type psoriasis
- Guttate psoriasis
- Generalized Pustular Psoriasis (GPP)
- Erythroderma
| Type of Psoriasis | Typical lesion | Body Distribution | Associated conditions[1][2][3][4][5][6] |
|---|---|---|---|
| Plaque-type psoriasis (most common) |
|
|
Triggers include: |
| Guttate psoriasis |
|
| |
| Generalized pustular psoriasis[7] |
|
|
|
| Erythrodermic psoriasis (most severe) |
|
|
|
Subphenotypes
Several further subphenotypes have been named according to:
- Distribution (localized vs. widespread)
- Anatomical localization (flexural- also called inverse, scalp, palms/soles/nail)
- Size (large vs. small)
- Thickness (thick vs. thin) of plaques
- Onset (early vs. late)
- Disease activity (active vs. stable)
Classification according to severity
Psoriasis is usually graded as:
- Mild (affecting less than 3% of the body)
- Moderate (affecting 3-10% of the body)
- Severe
Degree of severity
The degree of severity is generally based on the following factors:
- The proportion of body surface area affected
- Disease activity (degree of plaque redness, thickness and scaling)
- Response to previous therapies
- The impact of the disease on the person.
Psoriasis Area Severity Index (PASI)
The Psoriasis Area Severity Index (PASI) is the most widely used measurement tool for psoriasis. PASI combines the assessment of the severity of lesions and the area affected into a single score in the range 0 (no disease) to 72 (maximal disease).[8] The PASI can be too unwieldy to use outside of trials, which has led to attempts to simplify the index for clinical use.[9]
Other types of psoriasis
- Flexural psoriasis (inverse psoriasis) appears as smooth inflamed patches of skin. It occurs in skin folds, particularly around the genitals (between the thigh and groin), axillae, under an overweight stomach (pannus), and under the breasts (inframammary fold). It is aggravated by friction and sweat, and is vulnerable to fungal infections.
- Nail psoriasis produces a variety of changes in the appearance of finger and toe nails. These changes include discolouring under the nail plate, pitting of the nails, lines going across the nails, thickening of the skin under the nail, and the loosening (onycholysis) and crumbling of the nail.
- Drug-induced psoriasis
- Napkin psoriasis
- Seborrheic-like psoriasis
- Pustular psoriasis
-
Photograph of an arm covered with plaque psoriasis. -
Psoriasis nail pitting
References
- ↑ Pouplard C, Brenaut E, Horreau C, Barnetche T, Misery L, Richard MA, Aractingi S, Aubin F, Cribier B, Joly P, Jullien D, Le Maître M, Ortonne JP, Paul C (2013). "Risk of cancer in psoriasis: a systematic review and meta-analysis of epidemiological studies". J Eur Acad Dermatol Venereol. 27 Suppl 3: 36–46. doi:10.1111/jdv.12165. PMID 23845151.
- ↑ Gelfand JM, Yeung H (2012). "Metabolic syndrome in patients with psoriatic disease". J Rheumatol Suppl. 89: 24–8. doi:10.3899/jrheum.120237. PMC 3670770. PMID 22751586.
- ↑ Skroza N, Proietti I, Pampena R, La Viola G, Bernardini N, Nicolucci F, Tolino E, Zuber S, Soccodato V, Potenza C (2013). "Correlations between psoriasis and inflammatory bowel diseases". Biomed Res Int. 2013: 983902. doi:10.1155/2013/983902. PMC 3736484. PMID 23971052.
- ↑ Abel EA, DiCicco LM, Orenberg EK, Fraki JE, Farber EM (1986). "Drugs in exacerbation of psoriasis". J. Am. Acad. Dermatol. 15 (5 Pt 1): 1007–22. PMID 2878015.
- ↑ Tauscher AE, Fleischer AB, Phelps KC, Feldman SR (2002). "Psoriasis and pregnancy". J Cutan Med Surg. 6 (6): 561–70. doi:10.1177/120347540200600608. PMID 12362257.
- ↑ Boyd AS, Menter A (1989). "Erythrodermic psoriasis. Precipitating factors, course, and prognosis in 50 patients". J. Am. Acad. Dermatol. 21 (5 Pt 1): 985–91. PMID 2530253.
- ↑ Baker H, Ryan TJ (1968). "Generalized pustular psoriasis. A clinical and epidemiological study of 104 cases". Br. J. Dermatol. 80 (12): 771–93. PMID 4236712.
- ↑ "Psoriasis Update -Skin & Aging". Retrieved 2007-07-28.
- ↑ Louden BA, Pearce DJ, Lang W, Feldman SR (2004). "A Simplified Psoriasis Area Severity Index (SPASI) for rating psoriasis severity in clinic patients". Dermatol. Online J. 10 (2): 7. PMID 15530297.