The Psoriatic Disease Assessment Index (PSODAI) Score to Evaluate Systemic Involvement of Psoriasis

Yanhua Liang,1 Baoqing Deng,2 Epipode Ntawuyamara,3 Hervé Bachelez,4 Fuxi Wang,5 Hao Zhang,6 Zhenying Zhang,7 Zhengfeng Li,7 Lin Dang,8 Yajie Wang,1 Xianbiao Zou,9 Li Wang,10 Dejian Duan,11 Hongxiang Chen,12 Wenjun Zheng,13 Hui Huang,14 Min Zhang,15 Qingxian Cai,16 Ye Chen,17 Yingli Zhang,18 Zeyuan Lu,19 Yalin Ren,20 Jinxian Huang21 1Department of Dermatology, Cosmetology and Venereology, Shenzhen Hospital, Southern Medical University, Shenzhen, Guangdong, People’s Republic of China; 2Department of Dermatology, Shenzhen Baoan Center for Chronic Disease Control, Shenzhen, People’s Republic of China; 3Department of Dermatology and Venereology, University Teaching Hospital of Kamenge, University of Burundi, Bujumbura, Burundi; 4Department of Dermatology, Hôpital Saint-Louis, APHP & INSERM U1183, Imagine Institute for Human Genetic Diseases, Paris Cité University, Paris, France; 5Department of Dermatology, The Second People’s Hospital of Shenzhen, Shenzhen, Guangdong, People’s Republic of China; 6Department of Dermatology, Shenzhen Center for Chronic Disease Control, Shenzhen Institute of Dermatology, Shenzhen, Guangdong, People’s Republic of China; 7Department of Dermatology, the University of Hong Kong-Shenzhen Hospital, Shenzhen, Guangdong, People’s Republic of China; 8Department of Dermatology, Longgang Central Hospital, Shenzhen, Guangdong, People’s Republic of China; 9Department of Dermatovenerology & Medical Cosmetology, South China Hospital, Medical School, Shenzhen University, Shenzhen, People’s Republic of China; 10Department of Dermatology, Shenzhen Hospital Beijing University of Chinese Medicine, Shenzhen, People’s Republic of China; 11Department of Dermatology, Shenzhen Bao’an Chinese Medicine Hospital, Guangzhou University of Chinese Medicine, Shenzhen, People’s Republic of China; 12Department of Dermatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Shenzhen, Guangdong, People’s Republic of China; 13Department of Dermatology and Venereology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, People’s Republic of China; 14Department of Cardiology, The Eighth Affiliated Hospital of Sun Yat-Sen University, Shenzhen, People’s Republic of China; 15Department of Respiratory, The Second People’s Hospital of Shenzhen, Shenzhen, Guangdong, People’s Republic of China; 16National Clinical Research Center for Infectious Diseases, The Third People’s Hospital of Shenzhen, The Second Affiliated Hospital of Southern University of Science and Technology, Shenzhen, Guangdong, People’s Republic of China; 17Department of Gastroenterology, Integrative Clinical Microecology Center, Shenzhen Hospital, Southern Medical University, Shenzhen, Guangdong, People’s Republic of China; 18Shenzhen Mental Health Center, Shenzhen Kangning Hospital, Shenzhen, Guangdong, People’s Republic of China; 19Department of Endocrinology, The Eighth Affiliated Hospital of Sun Yat-sen University, Shenzhen, People’s Republic of China; 20Department of Ophthalmology, The University of Hong Kong-Shenzhen Hospital, Shenzhen, People’s Republic of China; 21Department of Medicine, Division of Rheumatology, The University of Hong Kong-Shenzhen Hospital, ShenzheN, Guangdong, People’s Republic of ChinaCorrespondence: Yanhua Liang, Department of Dermatology, Cosmetology and Venereology, Shenzhen Hospital, Southern Medical University, 13 Xinhu Road, Shenzhen, Guangdong, 518101, People’s Republic of China, Tel +86-755-23360448, Email [email protected]: To the best of our knowledge, no validated scoring instrument currently exists that comprehensively evaluates both cutaneous manifestations and systemic comorbidities of psoriasis. This multicenter study aimed to develop and validate a novel multidimensional scoring system addressing this clinical gap.Methods: Under the guidance of the Shenzhen Psoriasis Academy, we conducted seven expert meetings to analyze existing evidence from PubMed, Wanfang, and CNKI databases. Through iterative Delphi consensus processes involving 26 specialists across 10 disciplines, we established the Psoriasis Disease Assessment Index (PSODAI). This 60-point composite instrument evaluates cutaneous involvement and nine key organ/system comorbidities. An accompanying online calculator (http://www.psodai.com.cn/) was developed for clinical implementation. Validation involved 254 psoriasis patients from six tertiary centers, with comparative analyses against PASI and DLQI metrics.Results: The PSODAI framework stratifies disease severity as mild (0– 20), moderate (21– 40), and severe (41– 60). Comparative analysis revealed comparable proportions of moderate-to-severe cases between PSODAI and conventional tools (PASI/DLQI) (p> 0.05). Notably, 11 patients (4.3%) classified as severe by PASI were re-categorized as mild through PSODAI’s systemic evaluation, primarily due to limited extracutaneous manifestations.Conclusion: As the first comorbidity-integrated assessment tool, PSODAI enables cross-specialty collaboration for holistic patient management. Its clinical adoption may facilitate timely comorbidity detection and preventive interventions. Further multicenter validation is warranted to confirm these preliminary findings.Keywords: psoriasis, comorbidity, disease severity, systemic scoring, consensus