Global Expert Opinion on Psoriasis Severity Established

psoriasis on the elbow
psoriasis on the elbow
This statement rejects the mild, moderate, and severe categories in favor of a dichotomous definition: patients with psoriasis should be classified as either candidates for topical therapy or candidates for systemic therapy.

Global experts on psoriasis have developed a consensus statement on the classification of psoriasis severity and on identifying patients who are candidates for either topical or systemic therapy. The findings from the council were published in the Journal of the American Academy of Dermatology.

A Delphi exercise was performed by psoriasis experts from 32 countries who were members of the nonprofit International Psoriasis Council. The collective experience of the experts was used to develop a definition of psoriasis disease severity that can be useful in clinical and research settings.

During the exercise, experts participated in a brainstorming session, a total of two voting rounds, and a consensus meeting. A representative from each International Psoriasis Council corporate sponsor was invited to participate in the brainstorming session, but not the voting or the consensus meeting.

A total of 78 anonymous statements made by the psoriasis experts were collected during the exercise, including 68 statements from the International Psoriasis Council board and councilors and 10 statements from corporate sponsors. After voting, the final consensus statement agreed on by participants was that patients with psoriasis should be classified as candidates either for topical therapy or for systemic therapy. According to the statement, patients considered candidates for systemic therapy should have psoriatic body surface area of >10%, have disease involving special areas (ie, face, palms, soles, genitalia, scalp, or nails), and/or have experienced failed topical therapy.

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A limitation of the effort included the lack of patients and practicing dermatologists during the exercise and voting process.

The committee hopes “this new consensus statement will extend to the realm of clinical research and allow expanded access of psoriasis patients into clinical trials.”

Disclosure: Several study authors declared affiliations with the pharmaceutical industry. Please see the original reference for a full list of authors’ disclosures.

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Strober B, Ryan C, van de Kerkhof P, et al. Re-Categorization of psoriasis severity: Delphi consensus from the international psoriasis council [published online August 16, 2019]. J Am Acad Dermatol. doi:10.1016/j.jaad.2019.08.026