Jemec G B, Wulf H C
Department of Dermatology, National University Hospital (Rigshospitalet), University of Copenhagen, Denmark.
Acta Derm Venereol. 1997 Sep;77(5):392-3. doi: 10.2340/0001555577392393.
The lack of standard systems for assessment of disease severity poses a problem for the introduction of rational quality control in dermatology. The scoring systems often involve assessment of the same aspects of disease, and it may therefore be conceivable that one system could potentially be applied to routine clinical work and form the basis of disease quantification in dermatology. This study was undertaken to compare PASI (Psoriasis Area and Severity Index) and SCORAD (SCOring index of Atopic Dermatitis) scoring systems, to assess disease severity in patients with atopic dermatitis and psoriasis. Patients with psoriasis (14) and atopic dermatitis (14) were scored with both systems, and correlation coefficients and multiple regression coefficients were calculated. A significant correlation between SCORAD and PASI was found (rs = 0.66). Correlation coefficients were highest (rs = 0.87) when only atopic patients were studied, and lowest (rs = 0.57) when only psoriatic patients were studied. Assessments of area and erythema are suggested as candidates for a generalised scoring systems for dermatological disease. The results suggest that in spite of the overlap between the two score systems, significant diagnosis-specific differences exist, and neither PASI nor SCORAD is an optimal general dermatological scoring system for disease severity. Additional methodological developments are necessary.
缺乏用于评估疾病严重程度的标准系统给皮肤科引入合理的质量控制带来了问题。评分系统常常涉及对疾病相同方面的评估，因此可以设想，一个系统有可能应用于日常临床工作并构成皮肤科疾病量化的基础。本研究旨在比较银屑病面积和严重程度指数（PASI）与特应性皮炎评分指数（SCORAD）评分系统，以评估特应性皮炎和银屑病患者的疾病严重程度。对14例银屑病患者和14例特应性皮炎患者使用这两种系统进行评分，并计算相关系数和多元回归系数。发现SCORAD与PASI之间存在显著相关性（rs = 0.66）。仅研究特应性患者时相关系数最高（rs = 0.87），仅研究银屑病患者时相关系数最低（rs = 0.57）。面积和红斑评估被建议作为皮肤病通用评分系统的候选指标。结果表明，尽管这两种评分系统存在重叠，但仍存在显著的疾病特异性差异，PASI和SCORAD都不是评估疾病严重程度的最佳通用皮肤科评分系统。还需要进一步的方法学发展。
