An evaluation was made of a fully automated index of psoriasis, termed Computer-assisted Area and Severity Index (CASI). This method requires taking digital photographs of the target skin area(s) with a colour reference marker, Casmatch®. The CASI evaluates the severity of the psoriasis from the size and redness of the lesion(s). In five patients with mild psoriasis vulgaris mainly observed on their trunk, 18 photographs of the trunk were taken every 2 weeks. Three of the five patients [Psoriasis Area and Severity Index (PASI) of 3.0, 3.6 and 10.1, respectively] were treated with oral ciclosporin 3 mg/kg/day for 4 weeks. The mean ± SD area of lesion selected by a dermatologist was 2.3 ± 1.3% of the total skin area. This method achieved extraction performance for psoriasis of 72.1 ± 19.4% for sensitivity and 97.4 ± 2.0% for specificity. CASI correlated strongly with PASI (r = 0.92), but not with Skindex16® (r = 0.35). Although only erythema was evaluated, our preliminary results indicate that this method is capable of quantifying psoriasis lesions.
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