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We propose the following definitions of moderate\/severe disease: PASI\u2003&gt;\u200310 or BSA\u2003&gt;\u200310 or DLQI\u2003&gt;\u200310 for plaque\u2010psoriasis; BSA\u2003\u2265\u200310 or DLQI\u2003\u2265\u200310 for the other psoriatic skin lesions; DLQI\u2003\u2265\u200310 or meaningful values of the NAPSI or mNAPSI for psoriatic nail involvement; \u2265\u20031 inflamed joint + patient global VAS<jats:sup>3<\/jats:sup>4 + physician's judgement or arthritic joint deformities or radiographic joint damage plus \u2265\u20035 inflamed small joints or \u2265\u20031 large joints for peripheral joint involvement; \u2265\u20031 digit with dactylitis and \u2265\u20031 enthesitic sites + patient global VAS<jats:sup>3<\/jats:sup>4 + physician's judgement for dactylitis and enthesitis. BASDAI\u2003\u2265\u20034 + physician's judgement for spondylitis; recurrent flares or risk of developing irreversible damage for uveitis. Other assessment instruments can be used if the physician is more familiar with them and if they have been validated.<\/jats:p><jats:p><jats:bold>Conclusion\u2002<\/jats:bold> We provide a shared dermatological and rheumatological proposal for the use of biological agents in PD.<\/jats:p>","DOI":"10.1111\/j.1468-3083.2009.03474.x","type":"journal-article","created":{"date-parts":[[2009,10,23]],"date-time":"2009-10-23T10:13:52Z","timestamp":1256292832000},"page":"578-586","source":"Crossref","is-referenced-by-count":11,"title":["An Italian shared dermatological and rheumatological proposal for the use of biological agents in psoriatic disease"],"prefix":"10.1111","volume":"24","author":[{"given":"A","family":"Marchesoni","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"G","family":"Altomare","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M","family":"Matucci\u2010Cerinic","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"N","family":"Balato","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"I","family":"Olivieri","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C","family":"Salvarani","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"T","family":"Lotti","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R","family":"Scarpa","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"GA","family":"Vena","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"G","family":"Valesini","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A","family":"Giannetti","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2010,4,9]]},"reference":[{"key":"e_1_2_5_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2008.02.039"},{"key":"e_1_2_5_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2008.02.040"},{"key":"e_1_2_5_4_2","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2008.094946"},{"key":"e_1_2_5_5_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2133.2005.06893.x"},{"key":"e_1_2_5_6_2","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/keh514"},{"key":"e_1_2_5_7_2","first-page":"70","article-title":"Recommendations of the Italian Society for Rheumatology for the use of biologic (TNF\u2010alpha blocking) agents in the treatment of psoriatic arthritis","volume":"24","author":"Salvarani C","year":"2006","journal-title":"Clin Exp Rheumatol"},{"key":"e_1_2_5_8_2","first-page":"1228","article-title":"Towards international guidelines for the management of psoriatic arthritis","volume":"33","author":"Gladman DD","year":"2006","journal-title":"J Rheumatol"},{"key":"e_1_2_5_9_2","first-page":"1422","article-title":"Therapies for peripheral joint disease in psoriatic arthritis. 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