Evaluation of Efficacy of Indices in Psoriasis in Relation to Severity and Improvement in Therapy

Abstract

BACKGROUNDPsoriasis is a chronic disfiguring, inflammatory and proliferative condition of the skin in which both the genetic and environmental factors have a critical role. Many environmental factors like the trauma, infection, drugs, sunlight, metabolic factors, psychogenic factors, alcohol and smoking have been linked to psoriasis and have been implicated in initiation of disease process and exacerbation of pre-existing disease treatment. METHODSThe present study is conducted on a total of 40 patients, who presented with chronic plaque psoriasis to Department of DVL, Osmania General Hospital, Hyderabad, from September 2014 to July 2015. All the 40 cases were subjected to thorough clinical examination and investigations. We performed the calculations of BSA, PGA, PASI, PLASI in the cases. RESULTSThe mean results of BSA, PGA, PASI, PLASI before and after 8 weeks of treatment with methotrexate were calculated. The mean score before and after treatment therapy differed significantly (p <0.0001). Largest absolute difference was found with PLASI (35.1) followed by PASI (19), BSA (12.8), PGA (4). Largest relative difference was found with PLASI (86.32%), PASI (84.16%), PGA (80%) and BSA (75.75%). CONCLUSIONSStrength of each correlation was compared. The correlation between PLASI and PASI (r=0.932) was significantly stronger than correlation between any other two indices. Correlation between PLASI and BSA (r=0.593) was found to be weakest among all other indices. Correlation with PGA with PASI, PLASI was weaker than correlation between PASI and PLASI. In our study, the slope of the regression for PLASI (b = 3.319) vs. PASI (b = 2.462) indicates that PLASI is more accurate than PASI. In the regression analyses, all other slopes were less than unity indicating that the severity differentiation was inferior, especially when BSA was involved in the analysis. KEYWORDSPsoriasis, BSA, PGA, PASI, PLASI.HOW TO CITE THIS ARTICLE: Ananthula VK, Prasad KN, Prasad JVDS, et al. Evaluation of efficacy of indices in psoriasis in relation to severity and improvement in therapy.