Understanding Psoriasis Types & PASI Severity Scoring

Why Psoriasis Classification Matters

Psoriasis is not a single condition — it encompasses several distinct types, each with different clinical features, triggers, and treatment responses. Understanding your specific type of psoriasis and its severity is essential for effective treatment planning.

Cuba's dermatologists use the PASI (Psoriasis Area and Severity Index) scoring system to objectively measure psoriasis severity and track treatment response. This standardized tool allows clinicians to quantify the extent and intensity of psoriasis, providing a baseline for measuring improvement and comparing treatment outcomes.

For patients considering Coriodermina treatment in Cuba, understanding your psoriasis type and PASI score helps set realistic expectations and ensures the treatment plan is tailored to your specific condition.

Types of Psoriasis

The five main types of psoriasis include:

• Plaque psoriasis (psoriasis vulgaris) — The most common form (80-90% of cases), characterized by raised, red patches covered with silvery-white scales. Typically appears on elbows, knees, scalp, and lower back. This is the primary type treated with Coriodermina. • Guttate psoriasis — Small, drop-shaped lesions scattered across the torso, arms, and legs. Often triggered by streptococcal throat infections. More common in children and young adults. May respond well to treatment and can sometimes resolve permanently. • Inverse psoriasis (flexural) — Smooth, red patches in skin folds (armpits, groin, under breasts, around genitals). Aggravated by friction and sweating. Without the silvery scales of plaque psoriasis. Coriodermina is suitable for these sensitive areas. • Pustular psoriasis — White pus-filled blisters (pustules) surrounded by red skin. Can be localized (palms and soles) or generalized (entire body). Generalized pustular psoriasis is serious and requires systemic treatment. • Erythrodermic psoriasis — A rare, severe form where redness and scaling cover nearly the entire body. Can cause severe itching, pain, and fluctuating body temperature. Requires immediate medical attention and systemic treatment.

Coriodermina is primarily indicated for plaque, guttate, and inverse psoriasis. Pustular and erythrodermic psoriasis typically require systemic treatment (oral medications or biologics) rather than topical therapy alone.

The PASI Scoring System

The Psoriasis Area and Severity Index (PASI) is the gold standard for measuring psoriasis severity in clinical practice and research. It evaluates four body regions — head/neck, upper limbs, trunk, and lower limbs — assessing three severity parameters plus the area of involvement:

For each body region, the dermatologist scores: • Erythema (redness) — 0 (none) to 4 (very severe) • Induration (thickness) — 0 (none) to 4 (very severe) • Desquamation (scaling) — 0 (none) to 4 (very severe) • Area involved — 0 (0%) to 6 (90-100%)

These scores are combined using a weighted formula (the head/neck and arms have lower weights than the trunk and legs because they represent smaller body surface areas) to produce a total PASI score ranging from 0 to 72.

PASI severity categories: • Mild psoriasis: PASI < 7 • Moderate psoriasis: PASI 7-12 • Severe psoriasis: PASI > 12

In clinical trials, a 'PASI 75' response (75% reduction in PASI score from baseline) is a common benchmark for treatment success. Cuba's dermatologists use PASI scoring at the initial assessment and at follow-up visits to objectively measure treatment response.

How PASI Guides Treatment

The PASI score, combined with the psoriasis type and the patient's overall health, guides the treatment approach:

• Mild psoriasis (PASI < 7) — Topical treatment with Coriodermina is typically the first-line approach. Phototherapy may be added for enhanced effect. Most patients in this category are excellent candidates for Coriodermina treatment in Cuba. • Moderate psoriasis (PASI 7-12) — Topical treatment may be combined with phototherapy (narrowband UVB). Coriodermina can be effective, but results may be more gradual. The dermatologist evaluates whether topical therapy alone is sufficient or if systemic treatment should be considered. • Severe psoriasis (PASI > 12) — May require systemic treatment (oral medications like methotrexate, cyclosporine, or acitretin; or biologic therapies). Coriodermina may be used as a complementary topical treatment alongside systemic therapy, but topical treatment alone is unlikely to be sufficient for extensive disease.

The PASI score is also used to track treatment response over time. Patients receive a PASI assessment at the beginning of treatment in Cuba and at follow-up, providing objective evidence of improvement (or lack thereof). This data helps the dermatology team adjust the treatment plan as needed.