Reliability of the Roenigk Classification of Liver Damage After Methotrexate Treatment for Psoriasis: A Clinicopathologic Study of 160 Liver Biopsy Specimens

OBJECTIVE To determine the interobserver reliability of the Roenigk score as a classification system of liver damage and its possible consequences for clinical practice. DESIGN Retrospective study. SETTING Academic research. PATIENTS One hundred sixty liver biopsy specimens from patients with psoriasis receiving methotrexate treatment were rereviewed and analyzed blindly by an experienced pathologist with an interest in liver pathologic conditions. MAIN OUTCOME MEASURE Interobserver variation was evaluated using κ statistics. RESULTS A high concordance was present in the evaluation of the Roenigk grade of fibrosis (weighted κ = 0.73; 95% confidence interval, 0.63-0.83). Agreement was good regarding the number of biopsy specimens for patients whose clinical management should be changed (κ = 0.71; 95% confidence interval, 0.56-0.87). CONCLUSION The Roenigk classification in the assessment of liver fibrosis is a reliable scoring system.Arch Dermatol. 2007;143(12):1515-1519-->