Dirschka, T., Pellacani, G., Micali, G., Malvehy, J., Stratigos, A.J., Casari, A., Schmitz, L. and Gupta, G. (2017) A proposed scoring system for assessing the severity of actinic keratosis on the head: actinic keratosis area and severity index. Journal of the European Academy of Dermatology and Venereology, 31(8), pp. 1295-1302. (doi: 10.1111/jdv.14267) (PMID:28401585)
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Abstract
Background: Actinic keratosis (AK) severity is currently evaluated by subjective assessment of patients. Objectives: To develop and perform an initial pilot validation of a new easy-to-use quantitative tool for assessing AK severity on the head. Methods: The actinic keratosis area and severity index (AKASI) for the head was developed based on a review of other severity scoring systems in dermatology, in particular the psoriasis area and severity index (PASI). Initial validation was performed by 13 physicians assessing AK severity in 18 AK patients and two controls using a physician global assessment (PGA) and AKASI. To determine an AKASI score, the head was divided into four regions (scalp, forehead, left/right cheek ear, chin and nose). In each region, the percentage of the area affected by AKs was estimated, and the severities of three clinical signs of AK were assessed: distribution, erythema and thickness. Results: There was a strong correlation between AKASI and PGA scores (Pearson correlation coefficient: 0.86). AKASI was able to discriminate between different PGA categories: mean (SD) AKASI increased from 2.88 (1.18) for ‘light’ to 5.33 (1.48) for ‘moderate’, 8.28 (1.89) for ‘severe’, and 8.73 (3.03) for ‘very severe’ PGA classification. The coefficient of variation for AKASI scores was low and relatively constant across all PGA categories. Conclusions: Actinic keratosis area and severity index is proposed as a new quantitative tool for assessing AK severity on the head. It may be useful in the future evaluation of new AK treatments in clinical studies and the management of AK in daily practice.
| Item Type: | Articles |
|---|---|
| Status: | Published |
| Refereed: | Yes |
| Glasgow Author(s) Enlighten ID: | Gupta, Dr Girish |
| Authors: | Dirschka, T., Pellacani, G., Micali, G., Malvehy, J., Stratigos, A.J., Casari, A., Schmitz, L., and Gupta, G. |
| College/School: | College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing |
| Journal Name: | Journal of the European Academy of Dermatology and Venereology |
| Publisher: | Wiley |
| ISSN: | 0926-9959 |
| ISSN (Online): | 1468-3083 |
| Published Online: | 12 April 2017 |
| Copyright Holders: | Copyright © 2017 European Academy of Dermatology and Venereology |
| First Published: | First published in Journal of the European Academy of Dermatology and Venereology 31(8):1295-1302 |
| Publisher Policy: | Reproduced in accordance with the copyright policy of the publisher |
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