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Special Article
February 2007

National Psoriasis Foundation Clinical Consensus on Disease Severity

Author Affiliations

Author Affiliations: Department of Dermatology, Eastern Virginia Medical School, Norfolk (Dr Pariser); College of Physicians and Surgeons of Columbia University, New York, NY, and Psoriasis Treatment Center of Central New Jersey, East Windsor (Dr Bagel); Department of Dermatology (Drs Gelfand and Van Voorhees) and Center for Clinical Epidemiology and Biostatistics (Dr Gelfand), University of Pennsylvania, Philadelphia; Murdough Family Center for Psoriasis, Case Western Reserve University/University Hospital of Cleveland, Cleveland, Ohio (Dr Korman); Clinical Immunology Research Center, University of Rochester School of Medicine & Dentistry, Rochester, NY (Dr Ritchlin); Ronald O. Perelman Department of Dermatology, New York University (Dr Strober), and Mount Sinai School of Medicine (Dr Lebwohl), New York; and National Psoriasis Foundation, Portland, Ore (Ms Rittenberg and Dr Horn). Ms Young works in a private practice in Dallas, Tex.

Arch Dermatol. 2007;143(2):239-242. doi:10.1001/archderm.143.2.239

Objectives  A task force of the National Psoriasis Foundation Medical Board was convened to evaluate the current severity criteria of mild, moderate, and severe psoriasis and to make recommendations concerning a 2-tiered categorization of severity based on current clinical practice and related to intent to treat.

Participants  This volunteer task force, led by David M. Pariser, MD, included Jerry Bagel, MD, Joel M. Gelfand, MD, MSCE, Neil J. Korman, MD, PhD, Christopher T. Ritchlin, MD, Bruce E. Strober, MD, PhD, Abby S. Van Voorhees, MD, and Melodie Young, MSN, RN, ANP. Meetings were held by teleconference and were coordinated and funded by the National Psoriasis Foundation.

Evidence  This task force reviewed psoriasis severity criteria and other published psoriasis consensus statements. Current standards of care and expert opinion were used to inform the process.

Consensus Process  Based on meetings of the task force and under the guidance of David M. Pariser, MD, a statement was drafted by Elizabeth J. Horn, PhD, presented to the task force, and reviewed and approved by the task force. This statement was then reviewed and approved by Robert E. Kalb, MD, Gerald G. Krueger, MD, and Alan Menter, MD. The National Psoriasis Foundation Medical Board reviewed and endorsed this statement by a majority vote on March 2, 2006, at the medical board meeting.

Conclusions  This clinical consensus statement proposes a 2-tiered system for plaque psoriasis therapy that reflects more accurately than the current system how patients are treated in clinical practice. This statement, focused on plaque psoriasis, is intended to assist medical professionals and insurance payers in understanding these 2 categories of patients with psoriasis and choosing appropriate therapies for these patients.