The reason that psoriasis is also commonly known as “psoriasis” in our lives, we may have heard the phrase “Chinese doctors do not cure ringworm, Western doctors do not cure asthma”, psoriasis as a skin disease that is difficult to cure, the status in the hearts of all patients is evident. But in fact, the reason why most patients have not been cured of psoriasis for a long time is that they have not found the right method, and if the information and indicators of the disease are clear, the treatment will be more comfortable.
In fact, there is a detailed set of diagnostic criteria for psoriasis in clinical practice. This criterion is not clear simply by relying on the naked eye or blood test, moreover, it should be evaluated according to the comprehensive situation of the patient.
1.Body surface area of involvement (BSA)
Rules of scoring
The BSA score is an index for calculating the overall lesion area of psoriasis, and BSA ≈ 1% means that the lesion area is the size of one palm, so this method of estimating the lesion area can roughly judge the severity of the disease.
Before performing the calculation, patients are compared to each other in terms of hand size, and transparencies can also be used to draw the range of the patient’s palm with an oil-based pen to accurately scale 1% of the palm.
Range and score showing graded status
Clinically, patients with BSA <2% are usually considered as mild, and the disease rarely affects the patient's quality of life and basically does not need to be treated.
BSA <2%, mild psoriasis
Patients with BSA of 2%-10% are defined as moderate, where the disease affects life and the patient expects treatment to improve the quality of life.
BSA 2%-10%, moderate psoriasis
Patients with BSA >10%, defined as severe, where the disease greatly affects quality of life and the patient is willing to accept adverse effects that will affect quality of life in order to alleviate or treat the disease. a DLQ1 score >10 is defined as severe (see below).
BSA >10%, severe psoriasis
In addition to the assessment of the extent of the patient’s skin lesions, clinical assessment of the impact of the disease on the patient’s quality of life is also needed to assist in the development of an appropriate treatment plan for the patient.
2.Dermatological Disease Quality of Life Index (DLQI)
Questionnaire content
The DLQI is often used internationally as a questionnaire specifically for patients with skin diseases, and can be used by patients with other diseases in addition to psoriasis, including vitiligo, acne, baldness and other skin diseases.
The questionnaire has 10 questions
(1) Symptoms as well as somatic sensations.
(2) Psychological feelings.
(3) Daily activities.
(4) Choice of clothing.
(5) social recreation.
(6) physical exercise.
(7) work.
(8) family or friend relationships.
(9) sexual life.
(10) Therapy.
Test scores and effects
Each question was scored on a 4-point scale, with 0 = none, 1 = a little, 2 = more pronounced, and 3 = very pronounced. The total score is 0-30, with the higher the score, the worse the quality of life.
A DLQI score of 0-1 does not have a significant impact on patients’ lives; a DLQI score of 2-5 has a mild impact on patients’ quality of life; a DLQI score of 6-10 has a moderate impact on patients’ quality of life; a DLQI score of 11-20 has a severe impact on patients’ quality of life, and a DLQI score of 21-30 has a The DLQI of 11-20 will have a severe impact on patients’ quality of life, and the DLQI of 21-30 will have a very severe impact on patients’ quality of life.
In addition to the above two assessment criteria, there are also other assessment criteria for psoriasis patients. Regardless of which criteria, they all have their own clinical significance for psoriasis patients.
3. The significance of graded diagnosis for the initiation of systemic therapy
The use of various ways to assess the condition is more conducive to the physician’s choice of the manner and timing of systemic treatment, more conducive to guiding the clinician’s treatment practice, and can reduce situations such as under-treatment due to underestimation of the condition.
In addition to the consultation and formal treatment with the help of professional doctors, patients also need to make their own efforts. Therefore, patients also need to establish a correct understanding of the disease in their daily life, as well as a clear detailed process of treating the disease.
4.Patients need to establish the correct treatment awareness
Patients need to realize that psoriasis is a chronic disease, which seriously affects the quality of life but is not contagious, and if treated early and reasonably can improve the quality of life and is generally not life-threatening. Patients must believe in science and fully realize that psoriasis is a disease induced or aggravated by bad living habits, psychological stress, infection or environmental factors, and should not listen to biased prescriptions and blindly seek a cure. Patients also need to carry out targeted health management and advocate a healthy lifestyle.
Patients are advised to visit psoriasis clinics in local hospitals and enter the follow-up queue to receive and receive individualized treatment and health education. At the same time, society as a whole should strengthen the popularization of psoriasis, so that the public knows that psoriasis is a non-contagious chronic disease, give patients understanding and respect, and eliminate their psychological worries.