Dermatology Assessment Forms for Clinicians

The DLQI (Dermatology Life Quality Index) is the most widely used skin-specific quality of life measure, taking 3 minutes to complete. It has 10 questions covering symptoms, daily activities, leisure, work/school, relationships, and treatment. Scores range 0-30: 0-1 no effect, 2-5 small effect, 6-10 moderate effect, 11-20 very large effect, 21-30 extremely large effect on quality of life. A change of 4+ points is clinically meaningful.

PASI (Psoriasis Area and Severity Index) is the gold standard for measuring psoriasis severity, scored 0-72. It assesses erythema (redness), induration (thickness), desquamation (scaling), and body surface area across 4 body regions. Severity bands: 0-5 mild, 5-10 moderate, 10+ severe. Treatment goals are often PASI 75 (75% improvement) or PASI 90. PASI is clinician-administered and takes 5-10 minutes.

PASI is clinician-administered during physical examination, providing precise measurements for clinical trials and specialist consultations. SAPASI (Self-Administered PASI) is patient-completed using simplified body diagrams and visual scales, taking 5 minutes at home. SAPASI correlates well with PASI (r=0.8+) and is practical for remote monitoring between appointments. Use PASI for formal assessment, SAPASI for tracking.

Both measure eczema severity but differ in approach. EASI (Eczema Area and Severity Index) is purely objective, measuring extent and 4 clinical signs, scored 0-72. SCORAD includes subjective symptoms (itch, sleep loss) alongside clinical signs, scored 0-103. SCORAD: <25 mild, 25-50 moderate, >50 severe. For patient self-assessment, use PO-SCORAD (Patient-Oriented SCORAD) which patients complete at home.

Use PO-SCORAD (Patient-Oriented SCORAD) for remote eczema monitoring. Patients complete it at home in 5 minutes, assessing affected area, intensity of symptoms, and subjective measures (itch/sleep). Scores correlate well with clinician SCORAD. Have patients complete weekly or before each appointment to track treatment response. ClientForms provides automatic scoring and visual trend charts.

PEST (Psoriasis Epidemiology Screening Tool) is a 5-item questionnaire taking 2 minutes to screen for psoriatic arthritis in psoriasis patients. It asks about joint pain, swelling, nail pitting, heel pain, and digit swelling. A score of 3+ suggests psoriatic arthritis and warrants rheumatology referral. Up to 30% of psoriasis patients develop psoriatic arthritis, making screening important.

The UK Working Party diagnostic criteria (UKWP) is the most validated eczema screening tool worldwide, taking under 2 minutes. It asks one essential question (itchy skin in the past 12 months) plus 5 minor criteria about skin crease involvement, asthma/hay fever history, dry skin, age of onset, and visible eczema. Meeting the essential criterion plus 3+ minor criteria suggests atopic eczema. With 96% specificity, it has very few false positives.

CDLQI (Children's Dermatology Life Quality Index) measures skin condition impact on children aged 4-16, taking 3 minutes. Parents help younger children complete it. Like DLQI, scores range 0-30 with the same severity bands. It covers symptoms, feelings, school, relationships, sleep, and treatment. Use CDLQI for paediatric eczema, psoriasis, or other skin conditions affecting quality of life.

Patient-reported outcome measures (PROMs) that work well for home completion: DLQI and CDLQI (quality of life, 3 min), SAPASI (psoriasis severity, 5 min), PO-SCORAD (eczema severity, 5 min), NRS-Itch (itch intensity, 1 min), and Skindex-29 (comprehensive QoL, 10 min). These are ideal for telehealth, pre-appointment completion, or monitoring between visits.

Use NAPSI (Nail Psoriasis Severity Index) to assess nail involvement. It evaluates each nail for nail bed signs (onycholysis, oil spots, hyperkeratosis, splinter haemorrhages) and nail matrix signs (pitting, leukonychia, red spots, crumbling). Scores range 0-80 for fingernails (0-160 including toes). NAPSI tracks treatment response for biologics targeting nail disease.

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