The Cardiovascular
ToolsCalculators

Psoriasis Area and Severity Index (PASI)

Composite severity and extent score for plaque psoriasis across 4 body regions.

Psoriasis Area and Severity Index (PASI)
Head - erythema
Head - induration
Head - desquamation
Head - area involved
Trunk - erythema
Trunk - induration
Trunk - desquamation
Trunk - area involved
Upper limbs - erythema
Upper limbs - induration
Upper limbs - desquamation
Upper limbs - area involved
Lower limbs - erythema
Lower limbs - induration
Lower limbs - desquamation
Lower limbs - area involved
ResultPASI 0.0

Mild psoriasis (PASI <10).

Head contribution
0.0
Trunk contribution
0.0
Upper limb contribution
0.0
Lower limb contribution
0.0
Total PASI
0.0

When to use

  • Quantifying plaque psoriasis severity and extent for treatment decisions and monitoring response to systemic/biologic therapy.

Formula

PASI = 0.1x(Ehead+Ihead+Dhead)xAhead + 0.2x(Earms+Iarms+Darms)xAarms + 0.3x(Etrunk+Itrunk+Dtrunk)xAtrunk + 0.4x(Elegs+Ilegs+Dlegs)xAlegs, where E/I/D (erythema, induration, desquamation) are each graded 0-4 and A (area) is graded 0-6 by % body surface area involved per region. Range 0-72.

Pearls and pitfalls

  • PASI 75/90 (percentage improvement from baseline) is the standard trial endpoint, not the absolute score.
  • Weighting (head 0.1, upper limbs 0.2, trunk 0.3, lower limbs 0.4) approximates each region's proportion of total body surface area.

References

  1. Fredriksson T, Pettersson U. Severe psoriasis - oral therapy with a new retinoid. Dermatologica. 1978;157(4):238-244.