< See All Articles In Psoriasis

PASI, DLQI and PsO, oh my!

Living with psoriasis can be confusing, especially when it comes to measurement. We’re sharing our guide to understanding your scores, from PACI to DLQI

Psoriasis is different for everyone. For some, it’s a tiny annoying patch on your elbow, but for others it could cover your entire body. An itchy scalp may be driving a person crazy, while another could be more concerned by how self-conscious they feel about their blotchy skin. And while it may seem like the least of your worries, all of these symptoms – both physical and emotional – can and should be measured.

So let’s talk about that measurement – how your doctor determines just how bad your psoriasis really is, and whether or not it’s getting better or worse. You may be asking yourself, why does it even matter? We promise you it does, and here’s why: Imagine trying to treat a disease and not knowing how that treatment is working. What about trying to figure out what a person needs without knowing what their needs really are?

These are all things that measuring psoriasis can help address. If your doctor knows if your psoriasis is getting better or worse, and if they know how much of an impact your psoriasis is having on your life, they are better equipped to figure out the right treatment path for YOU.

What the heck is a PASI?!?

You may have heard your doctor talking about your ‘PASI’ score, and it might have left you completely confused. We’ll break it down for you: PASI is an abbreviation for the Psoriasis Area Severity Index. Now in human terms, that means it’s a way that doctors can measure how severe your psoriasis is.

So how does it work? The PASI looks at a number of factors – redness of skin (ugh), thickness of lesions (ouch), the extent of scaling (ahhhh!!), and the percentage of your body’s surface that’s affected. We know, we’re talking about all of things about psoriasis that you hate. But they’re important to understanding your condition.

Each area of your body (head and neck, arms and hands, trunk and lower body) is assessed and assigned a severity score, which is then used to calculate an overall score1. Want to see how it works? There’s a handy online calculator here for those of us who don’t have medical or math degrees.

A score below ten could mean your psoriasis may be mild to moderate, depending on the location of your psoriasis, and that first line treatments such as emollients and topical lotions might be all that’s required to improve matters. PASI scores above ten may be considered ‘moderate to severe’, suggesting more powerful forms of treatment might be appropriate2.

But, what about how you feel?

If you’re living with psoriasis, you know that the severity of the disease on your skin is only one piece of the puzzle. The emotional toll that psoriasis can take is a huge burden and certainly plays a role in the impact of psoriasis on your life. After all, even ‘mild’ psoriasis can keep you awake all night, or make you feel so self-conscious you don’t want to leave the house.

So how do we incorporate psoriasis’ impact on not just your physical being, but your well-being too? That’s where the Dermatology Life Quality Index (DLQI) comes in. And just as the name says, the DLQI is all about assessing how psoriasis is impacting your quality of life.3,4.

The DLQI is pretty simple – it’s a 10-question questionnaire that delves into everything from how your skin condition affects your ability to get up and get dressed in the morning, to how it impacts your career, emotional wellbeing, and social life. Sound interesting? Try the DQLI for yourself!

But what does it mean? Well, each question is scored from 0 to 3. These are then added up to give a final score that can range from 0 to 30. A score of 0/1 suggests that your psoriasis doesn’t really bother you, while a high one indicates it is having a significant impact on your day-to-day life and making you pretty miserable5. This may be the only instance where getting a 0 is the goal!

You’re more than just a number

The PASI and DLQI are quite different, but together, they give your doctor a clearer picture of how your psoriasis is affecting you physically, practically and mentally. Don’t know your scores? Just ask! Haven’t taken either test? Speak with your doctor about tracking your psoriasis progression. It’s your right to know, and in this case, knowledge really is power.

  1. Psoriasis assessment tools in clinical trials. Feldman SR, Krueger GG. Ann Rheum Dis. 2005 Mar;64 Suppl 2:ii65-8; discussion ii69-73. http://www.ncbi.nlm.nih.gov/pubmed/15708941 http://ard.bmj.com/content/64/suppl_2/ii65.full
  2. Responsiveness to change and interpretability of the simplified psoriasis index.  Chularojanamontri L, Griffiths CE, Chalmers RJ. J Invest Dermatol. 2014 Feb;134(2):351-8. http://www.ncbi.nlm.nih.gov/pubmed/?term=23897275 http://www.nature.com/jid/journal/v134/n2/full/jid2013318a.html
  3. Dermatology Life Quality Index (DLQI)--a simple practical measure for routine clinical use. Finlay AY, Khan GK. Clin Exp Dermatol. 1994 May;19(3):210-6. http://www.ncbi.nlm.nih.gov/pubmed/?term=8033378
  4. Two considerations for patients with psoriasis and their clinicians: what defines mild, moderate, and severe psoriasis? What constitutes a clinically significant improvement when treating psoriasis? Krueger GG et al. J Am Acad Dermatol. 2000 Aug;43(2 Pt 1):281-5. http://www.ncbi.nlm.nih.gov/pubmed/?term=10906652
  5. Website Cardiff University – DLQI Instructions for use and scoring. Last accessed: 09.12.15. http://sites.cardiff.ac.uk/dermatology/quality-of-life/dermatology-quality-of-life-index-dlqi/dlqi-instructions-for-use-and-scoring/

Related articles