Table 2.
Classification criteria for psoriasis from CPRWERG.
| Medical indexes | Symptom | Weight/score |
|---|---|---|
| Cutaneous psoriasis: Score 4 or above | ||
| Silver white scales | White scales, falling off in layers after scratching, called candle wax phenomenon | 1 |
| Film phenomenon | Scraping off the silvery white scales, a shiny reddish translucent film on the surface of the lesions exposes | 2 |
| Auspitz's sign | Scraping continues deeper, the lesions will show punctate spots of bleeding | 3 |
| Hyperkeratosis and parakeratosis | Thickened cornified layer and cell nuclei present in the cornified layer | 1 |
| Highly reduced or absent Granular Layer | Thinning or absence of a granular layer | 1 |
| Acanthosis with elongated rete ridges | Thickening of viable epidermal layers | 1 |
| Angiogenesis | Dilated and contorted blood vessels reach into the tips of the dermal papillae | 1 |
| Pustulosa psoriasis: Score 5 or above | ||
| Cutaneous psoriasis (Prerequisites) |
Current or previous history of cutaneous psoriasis or family history of psoriasis | 3 |
| Fever | Temperature≥ 37.5°C | 1 |
| Pustule | On the basis of generalized erythema, multiple aseptic pustules, densely distributed or fused into flakes | 2 |
| Pustules are easy to rupture and form flakes | 1 | |
| Subcorneal pustulosis | The pathological manifestation is the aggregation of neutrophils to form subcorneal pustulosis, Kogoj's spongy abscess | 1 |
| Erythroderma psoriasis: Score 5 or above | ||
| Cutaneous psoriasis (Prerequisites) |
Current or previous history of cutaneous psoriasis or family history of psoriasis | 3 |
| Skin lesion area is over 90% | Diffuse flushing, infiltration and swelling of the skin all over the body, accompanied by a large number of bran-like scales, with flaky normal skin island | 2 |
| Fever | Temperature ≥ 37.5°C | 1 |
| Systemic psoriasis: Score 6 or above | ||
| Cutaneous psoriasis (Prerequisites) (3 scores) | Current or previous history of cutaneous psoriasis or family history of psoriasis | 3 |
| Psoriatic arthritis (46, 69) (≥3 scores) | Finger (toe) nail changes | 1 |
| Rheumatoid factor negative | 1 | |
| Finger (toe) arthritis | 1 | |
| Joint pain lasting more than 1 month | 1 | |
| Imaging showed new bone formation around the joint | 1 | |
| Psoriasis with metabolic syndrome (10) (≥3 scores) | Increased waist circumference (Male>40 inches (102 cm) Female>35 inches (88 cm) | 1 |
| Hyperglycemia: fasting blood glucose: ≥ 6 mmol/l (100 mg/dL), and/or have been diagnosed with diabetes and treated | 1 | |
| Hypertension: systolic/diastolic blood pressure ≥130/85 mmHg, and/or diagnosed with hypertension and treated | 1 | |
| Fasting triglyceride ≥ 150 mg/dL | 1 | |
| HDL cholesterol male <40, female <50 mg/dL | 1 | |
| Psoriasis with diabetes (70) (≥3 scores) | HbA1c ≥ 6.5 % (≥ 48 mmol/mol) | 3 |
| Random blood glucose≥ 200 mg/dl (≥ 11.1 mmol/l) | 3 | |
| Fasting blood glucose ≥ 126 mg/dl (≥ 7.0 mmol/dl) | 3 | |
| Two hours postprandial blood glucose (2hPBG) ≥ 200 mg/dl (≥ 11.1 mmol/l) | 3 | |
| Psoriasis with cardiovascular disease (42) (≥3 scores) | Coronary heart disease | 3 |
| Atherosclerosis | 3 | |
| Hyperlipidemia | 3 | |
| hypertension | 3 | |
| Ischemic heart disease | 3 | |
| Psoriasis with nephropathy (≥3 scores) | Urine protein 1 + and above or 0.5 g/24 h | 3 |
| Hematuria or erythrocyte cast | 1 | |
| Abnormally increased Urea nitrogen | 1 | |
| Abnormally elevated creatinine | 3 | |
| Psoriasis with bowel disease (≥3 scores) | Confirmed Crohn's disease | 3 |
| Confirmed ulcerative colitis | 3 | |
| Psoriasis with brain disease (≥3 scores) | Depression/mania | 3 |
| Psychiatric symptoms | 3 | |
| Multiple sclerosis | 3 | |
| Psoriasis with pulmonary disease (42) (≥3 scores) | Interstitial lung disease | 3 |
| COPD | 3 | |
| Psoriasis with liver disease (≥3 scores) | Liver fibrosis | 3 |
| Abnormal liver function (needs to exclude drugs) | 3 | |
| cholecystitis | 3 | |
| Psoriasis with uveitis (≥3 scores) | Inflammation of iris, ciliary body or choroid tissue | 3 |
| Psoriasis with lupus erythematosus (≥3 scores) | ANA positive | 1 |
| Anti-ds-DNA or anti-Smith antibody Positive | 2 | |
| EULAR/ACR Classification criteria for systemic lupus erythematosus (71) | 10 | |
| Psoriasis with malignant tumors (42) (≥3 scores) | Squamous cell carcinoma/basal cell carcinoma | 3 |
| Malignant melanoma | 3 | |
| Cutaneous T cell lymphoma | 3 | |
| Hematological malignancies | 3 | |
| Other malignant tumors | 3 | |
CPRWERG, The Chinese Psoriasis Real-World Evidence Research Group.