Psoriasis — SCE Dermatology MCQ

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EasyInflammatory DermatosesPsoriasisSCE Dermatology

A 45-year-old woman with severe plaque psoriasis has been assessed and meets criteria for biologic therapy. According to BAD/NICE, which validated patient-reported outcome must be assessed alongside PASI to determine eligibility?

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Correct answer: C — DLQI (Dermatology Life Quality Index) ≥10

The correct answer is C, DLQI (Dermatology Life Quality Index) greater than 10. NICE technology appraisals for biologic therapy in plaque psoriasis require dual eligibility criteria: objective severity (PASI 10 or above, or PASI 20 or above for infliximab) combined with a validated quality of life measure, the DLQI, scoring greater than 10 (greater than 18 for infliximab). The DLQI is a dermatology-specific 10-item questionnaire capturing the impact of skin disease on daily activities, leisure, work, relationships and treatment, and its inclusion ensures biologics are reserved for patients whose disease is both severe and significantly life-impairing, not severity alone. This dual threshold reflects the rationale that PASI alone can under-represent disease burden, particularly with visible or high-impact site involvement, so a patient-reported outcome is mandated alongside the clinician-assessed score before funding approval.

Reference: https://www.nice.org.uk/guidance/conditions-and-diseases/skin-conditions