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A proposed scoring system for assessing the severity of actinic keratosis on the head: actinic keratosis area and severity index
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 (A...
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Published in: | Journal of the European Academy of Dermatology and Venereology 2017-08, Vol.31 (8), p.1295-1302 |
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Main Authors: | , , , , , , , , , , , , , , , , , , , , |
Format: | Article |
Language: | English |
Subjects: | |
Citations: | Items that this one cites Items that cite this one |
Online Access: | Get full text |
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Summary: | 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. |
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ISSN: | 0926-9959 1468-3083 |
DOI: | 10.1111/jdv.14267 |