https://orcid.org/0000-0001-6150-1229
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M. Beylot‐Barry, J. Seneschal, D. Tran, H. Bachelez, N. Beneton, A. Dupuy, P. Joly, D. Jullien, E. Mahé, C. Paul, M.‐A. Richard, E. Sbidian, M. Viguier, O. Chosidow, F. Tubach, Characteristics of patients with psoriasis with Psoriasis Area and Severity Index < 10 treated with biological agents: results from the French PsoBioTeq cohort, British Journal of Dermatology, Volume 185, Issue 5, 1 November 2021, Pages 1052–1054, https://doi.org/10.1111/bjd.20585
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A full list of affiliations is available in the Supporting Information.
O.C. and F.T. are joint last authors.
Funding statements and conflicts of interest are provided in the Supporting Information.
Dear Editor, The decision to initiate systemic therapy in psoriasis is based mainly on disease severity assessments, determined using physician‐derived scores. A commonly used assessment is the Psoriasis Area and Severity Index (PASI), with an absolute value of 10 or more indicating severe disease.1 How patients perceive the severity of psoriasis and physicians’ evaluations may be discordant, especially when lesions involve visible areas or are associated with itching. Such lesions can have a greater impact on quality of life (QoL),2 as evaluated using patient‐reported outcomes such as the Dermatology Life Quality Index (DLQI). Analysis of the Swedish PsoReg registry found that patients with high PASI and low DLQI were more likely to receive biologics than those with low PASI and high DLQI.3 A retrospective study of 54 patients showed that DLQI guides therapeutic decisions in patients with PASI ≤ 6, with improvement of both disease and QoL scores following systemic therapy.4 A recent international Delphi consensus challenged the severity criteria,5 and guidelines1, 6 propose considering systemic therapy when psoriasis involves impactful areas or is recalcitrant to topical therapy, whatever the PASI.
