Dermatology Scoring System — pharmaadvance.in

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🔬 Dermatology Scoring System

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Quality of Life

4 tools

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DLQI

Dermatology Life Quality Index

0–3010 questionsQoL

Rate each — 0 Not at all · 1 A little · 2 A lot · 3 Very much

DLQI Score

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Range 0–30 · Score >10 = biologic eligibility threshold

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cDLQI

Children's Dermatology Life Quality Index (4–16 yrs)

0–3010 questionsPaediatric

Parent/child-reported · 0=Not at all / Not relevant · 1=A little · 2=A lot · 3=Very much

cDLQI Score

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0–1 No effect · 2–6 Small · 7–12 Moderate · 13–18 Very large · 19–30 Extremely large effect on child's QoL

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CADI

Cardiff Acne Disability Index

0–155 questionsAcne QoL

Each item 0–3 · Reporting last month

CADI Score

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0–3 Minimal · 4–7 Moderate disability · 8–15 Severe disability

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PsoriQoL

Psoriasis-specific QoL index (25 items)

0–25True/FalsePsoriasis QoL

PsoriQoL is a 25-item patient-reported measure. Each item is answered True (1) or False (0). Higher score = worse QoL.

Items cover: physical function, emotional wellbeing, embarrassment, treatment burden, social activities. Validated specifically for plaque psoriasis. Administer the full patient-reported questionnaire; enter the count of "True" answers below.

Number of "True" answers 0–25

PsoriQoL Score

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0–8 Minimal impact · 9–17 Moderate · 18–25 Severe impact on QoL

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Skindex-16

Emotional & Functional Impact

0–1003 domainsSelf-report

Skindex-16 — 3 domains, each item rated 0–6 (Never → Always):
• Symptoms (4 items): itch, burn, pain, irritation
• Emotions (7 items): worry, embarrassment, frustration
• Functioning (5 items): daily tasks, social interactions

Domain score = mean × 100/6. Higher score = worse QoL.
Administer the validated paper/digital patient-report form.

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Psoriasis

7 tools

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PASI ⭐ Gold Standard

Psoriasis Area & Severity Index

0–724 regionsE+S+T × Area

Intensity 0–4 · Area: 0=0% 1=<10% 2=10-29% 3=30-49% 4=50-69% 5=70-89% 6=90-100%

PASI Score

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PASI 75 (≥75% reduction from baseline) = standard success benchmark

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BSA

Body Surface Area — % Skin Involved

0–100%Rule of 9s

Enter % involvement per region (1 palm ≈ 1%)

Head & Neck max 9%

Trunk Front max 18%

Back max 18%

Arms (both) max 18%

Legs (both) max 36%

Genitalia max 1%

Total BSA Involved

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PGA

Physician's Global Assessment

0–5Single score

Select overall disease severity

PGA Score

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Treatment target: PGA 0 or 1 (Clear / Almost Clear)

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PLSI

Psoriasis Log-based Severity Index

0–28Log scaleBSA-adjusted

PLSI uses a logarithmic transformation of BSA to account for non-linear perception of disease extent. Formula: PLSI = 3.5 × log₁₀(1 + BSA) × Severity grade (0–4)

BSA Involved (%) 0–100

Severity Grade

PLSI Score

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0–5 Mild · 6–14 Moderate · 15–28 Severe

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NAPSI

Nail Psoriasis Severity Index

0–16010 nailsMatrix + Bed

Scoring per nail:
Matrix signs (pitting, leukonychia, red spots in lunula, crumbling): 0=none, 1–4=quadrants involved
Nail Bed signs (onycholysis, oil drop, subungual hyperkeratosis, splinter haemorrhage): same 0–4 scale

NAPSI Score

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Each nail max 8 pts × 20 nails = 160 max · mNAPSI uses target nail only

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DAPSA

Disease Activity in Psoriatic Arthritis

0–1645 componentsPsA

Tender Joint Count (68 joints) 0–68

Swollen Joint Count (66 joints) 0–66

CRP (mg/dL) 0–20

Patient Global Assessment (VAS 0–10)

Patient Pain (VAS 0–10)

DAPSA Score

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Remission ≤4 · Low ≤14 · Moderate ≤28 · High >28

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Acne

6 tools

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GAGS

Global Acne Grading System

0–446 regionsLesion grade

Grade: 0=None · 1=Comedones · 2=Papules · 3=Pustules · 4=Nodules

GAGS Score

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IGA

Investigator's Global Assessment

0–4Single score

IGA Score

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Clinical trial endpoint: IGA ≤1

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Pillsbury Scale

Acne Grade I–IV (Classic)

Grade I–IVClassic

IComedones only

IIMild papulopustular

IIIModerate

IVNodulocystic

Pillsbury Grade

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Grade III–IV: consider systemic therapy

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Leeds Revised Acne Grading

0.5–12 Visual Reference Scale

0.5–12Visual scale

Leeds Grade

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Grade ≥5 = moderate–severe; consider oral therapy

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Goodman & Baron's Scar Score

Acne Scar Severity — Qualitative & Quantitative

Grade 1–4QualitativeAcne Scar

Qualitative Grading System (select dominant scar type)

Quantitative Score (optional) — Count × Weight

Quantitative weights: Macular (×1) · Mild atrophic rolling (×2) · Moderate atrophic (×3) · Punched-out/boxcar (×4) · Deep punched-out/ice-pick (×5) · Hypertrophic keloid (×7)

Macular (flat) scars

Mild atrophic / rolling

Moderate atrophic

Boxcar scars

Ice-pick scars

Hypertrophic/keloid

Acne Scar Score

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Quantitative score guides treatment intensity: mild <15 · moderate 15–30 · severe >30

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Androgenetic Alopecia (AGA)

2 tools

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Hamilton-Norwood Scale

Male Pattern Baldness (Types I–VII)

Type I–VIIMale AGAFrontal + Vertex

Select the Hamilton-Norwood type that best matches the patient

Hamilton-Norwood Type

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Type III–IV: topical minoxidil + finasteride · Type V–VII: consider hair transplant

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Ludwig / Savin Scale

Female Pattern Hair Loss (Grade I–III)

Grade I–IIIFemale AGACrown thinning

Select Ludwig grade for crown/vertex thinning in female patients

IMild diffuse thinning at the crown; frontal hairline preserved

IIModerate thinning; crown clearly visible, widened central parting

IIISevere — near-complete hair loss at crown; scalp fully visible

Ludwig Grade

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All grades: minoxidil 2–5% · investigate hormonal causes · Grade III: specialist referral

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Atopic Dermatitis

4 tools

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SCORAD

SCORing Atopic Dermatitis

0–103A/5 + 7B/2 + C

A — Extent (% BSA involved)

% Body Area Affected 0–100

B — Intensity signs (0=None · 1=Mild · 2=Moderate · 3=Severe)

C — Subjective symptoms (VAS 0–10 each)

Itch (last 3 days)

Sleep loss (last 3 nights)

SCORAD Score

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EASI

Eczema Area & Severity Index

0–724 regions

Signs 0–3 · Area 0–6

EASI Score

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EASI-50/75/90 = treatment benchmarks

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AD-PGA

AD Physician's Global Assessment

0–5Single scoreAtopic Derm

Select the overall AD severity grade

AD-PGA Score

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Target: AD-PGA 0–1 · Biologics eligibility: moderate–severe (≥3)

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ADSI

Atopic Dermatitis Severity Index

0–155 signs × 3Atopic Derm

Rate each sign 0–3: 0=None · 1=Mild · 2=Moderate · 3=Severe

ADSI Score

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0–5 Mild · 6–10 Moderate · 11–15 Severe

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Vitiligo

3 tools

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VASI

Vitiligo Area Scoring Index

0–100 HU × Depigment% 5 regions

1 Hand Unit (HU) = palm + 5 digits ≈ 1% BSA · Formula: Region VASI = Hand Units × Depigmentation% · Total VASI = Σ All Region Scores

📷 Depigmentation Visual Reference Guide

No depigmentation

10%

Specks only

25%

Pigmented > depigmented

50%

Equal pigment/depigment

75%

Depigmented > pigmented

90%

Speckled pigment

COMPLETELY WHITE

100%

Completely white — no pigment

VASI Score

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VASI-50/75/90 = treatment benchmarks · Max theoretical ~100

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Vitiligo BSA

% Body Surface Area depigmented

0–100%Rule of 9sVitiligo

Estimate % depigmented area per region (1 palm ≈ 1% BSA)

Head & Neck max 9%

Trunk (total) max 36%

Arms (both) max 18%

Legs (both) max 36%

Hands & Feet max 5%

Genitalia max 1%

Vitiligo BSA

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<10% Localised · 10–50% Generalised · >50% Universal vitiligo

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VIDA

Vitiligo Disease Activity Score

−1 to +4Activity

VIDA Score

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Urticaria

3 tools

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UAS7

7-day Urticaria Activity Score

0–427-day diary

Wheals 0–3 · Itch 0–3 per day

UAS7 Score

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Well-controlled ≤6 · Complete response = 0

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UCT

Urticaria Control Test

0–164 questions

UCT Score

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≥12 = well-controlled · <12 = poorly controlled

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AAS

Angioedema Activity Score

0–60HAE / CSU

Days with angioedema 1–28

AAS Score

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Melasma

2 tools

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MASI

Melasma Area & Severity Index

0–484 regions

MASI Score

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≥50% reduction = significant response

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Modified MASI (mMASI)

Simplified — excludes Homogeneity

0–24A × D onlyMelasma

mMASI = Σ (weight × Area × Darkness) — homogeneity excluded

mMASI Score

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mMASI 0–24 · Better inter-rater reliability than full MASI

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Hair Loss (Alopecia)

1 tool

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SALT

Severity of Alopecia Tool

0–100%4 quadrants

Top 40% of scalp

Right side 18%

Left side 18%

Back 24%

SALT Score

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S0=0% · S1=1-25% · S2=26-50% · S3=51-75% · S4=76-99% · S5=100%

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Hirsutism

1 tool

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Ferriman-Gallwey Score

Androgen-dependent hair growth in women

0–369 body sitesHirsutism

Score each site 0–4: 0=None · 1=Fine vellus · 2=Few terminal hairs · 3=More terminal hairs · 4=Frank hirsutism

Ferriman-Gallwey Score

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≥8 = hirsutism (European women) · ≥6 = hirsutism (Asian women) · Investigate for PCOS/adrenal/ovarian causes

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Pemphigus & Mucous Membrane Pemphigoid

2 tools >

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ABSIS

Autoimmune Bullous Skin Disorder Intensity Score

0–206Skin + MucosaePemphigus

ABSIS — Validated for pemphigus vulgaris and bullous pemphigoid. Skin component (max 150) + Oral mucosa component (max 56).

Skin Component — % BSA affected

Active blistering / erosions (% BSA) 0–100

Skin quality factor 0=None · 1=Mild seb/pain · 2=Moderate · 3=Severe/disabled

Oral Mucosa Component

Extent of oral involvement 0–4

Oral pain / difficulty eating 0–4

ABSIS Score

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Mild <17 · Moderate 17–45 · Severe >45 · Complete remission = 0

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PDAI

Pemphigus Disease Area Index

0–263Skin + Mucosa + ScalpPemphigus

Score activity (active lesions) and damage (post-inflammatory) for each region

PDAI Score

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Minimal disease activity ≤8 · Moderate 9–24 · Severe ≥25 · Activity subscores guide treatment decisions

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Erythroderma

1 tool

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EPICS

Erythroderma Severity & Prognosis Index

0–205 parametersErythroderma

EPICS — Validated tool for erythroderma severity assessment. Five clinical parameters, each scored 0–4.

Rate each parameter 0–4

EPICS Score

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0–6 Mild · 7–12 Moderate · 13–20 Severe erythroderma

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Hidradenitis Suppurativa (HS)

2 tools

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Hurley Staging System

HS Disease Staging (Stages I–III)

Stage I–IIIHS stagingHurley 1989

Select the Hurley stage that best represents the patient's HS

ISingle/multiple abscesses. No sinus tracts or scarring.

IIRecurrent abscesses with sinus tracts and scarring. Single or multiple widely separated lesions.

IIIDiffuse/broad involvement. Multiple interconnected sinus tracts and abscesses across the entire area.

Hurley Stage

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Stage I: topical · Stage II: oral antibiotics + biologics · Stage III: biologics + surgical

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IHS4

International Hidradenitis Suppurativa Severity Score

0–165Nodules+Abscesses+SinusesIHS4

IHS4 — Formula: (Nodules × 1) + (Abscesses × 2) + (Draining tunnels/sinuses × 4)

Inflammatory nodules count 0–50

Abscesses count 0–30

Draining tunnels / sinuses count 0–20

IHS4 Score

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Mild <4 · Moderate 4–10 · Severe >10

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Systemic / Connective Tissue Disease

3 tools

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MRSS

Modified Rodnan Skin Score (Systemic Sclerosis)

0–5117 sitesSSc / Scleroderma

MRSS — 17 body areas palpated and graded 0–3:
0 = Normal · 1 = Mild thickening · 2 = Moderate, can't pinch · 3 = Severe, bound to underlying tissue

MRSS Score

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0–14 Mild · 15–29 Moderate · ≥30 Severe SSc skin involvement

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SLEDAI-2K

SLE Disease Activity Index

0–10524 itemsSLE

SLEDAI-2K — Only score features present in the last 10 days. Each item has a weighted score (1–8).

SLEDAI-2K Score

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0=No activity · 1–5=Mild · 6–10=Moderate · 11–19=High · ≥20=Very high activity

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Vancouver Scar Scale

Keloid / Hypertrophic Scar Assessment

0–134 parametersScar

Assess each parameter of the scar

Vascularity (colour)

Pigmentation

Pliability

Height (thickness)

Vancouver Scar Scale

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0 = Normal skin · 13 = Severe scar · Guides scar treatment selection

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Severe Cutaneous Adverse Reactions (SCAR)

3 tools

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SCORTEN

SJS/TEN Mortality Predictor

0–7TEN / SJSMortality predictor

⚠️ SCORTEN — Validated ICU mortality predictor. Calculate within 24–48 h of admission. Each criterion = 1 point.

Age > 40 years+1

Malignancy (active)+1

Heart rate > 120 bpm+1

BSA detachment > 10% on day 1+1

Serum urea > 10 mmol/L (>28 mg/dL)+1

Serum glucose > 14 mmol/L+1

Serum bicarbonate < 20 mmol/L+1

SCORTEN Score

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Score	Predicted Mortality
0–1	3.2%
2	12.1%
3	35.3%
4	58.3%
≥5	90%

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CRISTEN Score

SJS-TEN Causality Assessment

0–12SJS / TENDrug causality

CRISTEN — Drug causality scale specific for SJS/TEN. Supplement to Naranjo for severe cutaneous reactions.

CRISTEN Score

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≥6 = Probable/Definite causality · 3–5 = Possible · <3 = Unlikely

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DRESS / RegiSCAR Score

Drug Reaction with Eosinophilia & Systemic Symptoms

−4 to +9RegiSCAR

DRESS RegiSCAR Score

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<2=No case · 2–3=Possible · 4–5=Probable · ≥6=Definite DRESS · 📋 File ADR Report →

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ADR Causality & Pharmacovigilance

2 tools

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Naranjo Scale ⭐ Gold Standard

ADR Causality Assessment

−4 to +1310 questions

Naranjo Score

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≥9 Definite · 5–8 Probable · 1–4 Possible · ≤0 Doubtful · 📋 File ADR Report →

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WHO-UMC

WHO Causality Categories

6 categoriesChecklist

Clinical Criteria

Plausible time relationship between drug intake and onset

Consistent with known pharmacology / toxicology

Improved on withdrawal (dechallenge positive)

Reappeared on re-administration (rechallenge positive)

Alternative cause cannot explain the event

Confirmed by objective evidence

Previously known adverse reaction to this drug

WHO-UMC Category

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Symptoms

1 tool

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VAS / NRS

Visual Analogue / Numeric Rating Scale

0–10Itch or Pain

Symptom type

Score 0=None · 10=Worst imaginable

Itch Score

None

VAS (10 cm line) and NRS (0–10 verbal) are clinically equivalent

· Pharmaadvance.in · Designed by Dr. Harkirat (PG) Department of Pharmacology