Alexandria, VA. December 30, 2025.
The National Psoriasis Foundation (NPF) today announced a new position statement clarifying the definition of psoriasis disease severity, addressing lingering misconceptions that limit patient access to appropriate care. This position statement was published today as a Health Policy and Practice article in press in the Journal of the American Academy of Dermatology.
“In recent years, NPF has been concerned,” says President and CEO, Leah Howard, J.D., “that outdated institutional definitions of severity have prevented patients from being able to access modern medications that may be capable of controlling their psoriasis.”
Dr. Andrew Blauvelt, Chair of the NPF Medical Board, noted that psoriasis is far more than a benign cosmetic condition and that outdated labels create ambiguity as clinicians and patients consider important clinical choices. “This is a chronic, systemic inflammatory disease that can lead to serious health consequences, including psoriatic arthritis and cardiovascular disease,” says Dr. Blauvelt. “Under-treatment of psoriasis places patients at high risk for developing these very serious issues. It was important for us to draw a very clear line for health care providers and insurance. We are saying that there is no middle ground and no ambiguity. A patient should be considered as having either 'mild' psoriasis, which can be managed with topical therapies, or a moderate-to-severe psoriasis, which makes these patients candidates for advanced therapies.”
This two-class system differs from historical practice where psoriasis severity was considered as being mild, moderate, or severe solely based on the surface area covered by psoriatic lesions. Under the new system, the NPF Medical Board is providing a resource to help patients and clinicians document the international consensus amongst psoriasis experts that:
- Moderate-to-severe psoriasis is not determined solely by body surface area (BSA) involvement of 10%.
- In addition, patients who cannot achieve adequate control with topical therapies or who have psoriasis involving high-impact sites (e.g., face, scalp, hands, feet, nails, or genitals) should also be considered as having “moderate-to-severe” disease.
- These patients are all candidates for advanced therapies, including phototherapy as well as modern systemic treatments. Today’s systemic treatments include a variety of safe and highly effective oral and biologic therapies that treat inflammation throughout the body.
NPF is not alone in this work, and has crafted its position with attention to work developed internationally by the International Psoriasis Council (Strober et al., 2020) and increasingly incorporated into clinical guidelines in the US and other countries. NPF has surveyed 4,129 patients on the topic and demonstrated that patients’ views of severity are aligned with this growing understanding that psoriasis severity must account for quality of life, treatment response, and lesion location, and not simply what is visible to others (Blauvelt et al., 2023).
Summarizing the new paper, Howard concluded, “People with psoriasis should never be denied advanced care because of outdated measures. This position helps ensure patient access to state-of-the-art treatment, and in doing so will improve these patients’ lives.”
About the National Psoriasis Foundation
The National Psoriasis Foundation is the leading nonprofit representing individuals with psoriasis and psoriatic arthritis. The mission of NPF is to drive efforts to cure psoriatic disease and improve the lives of more than 8 million individuals in the United States affected by this chronic immune-mediated disease. Learn more at psoriasis.org.