Psoriasis — DVA SoP factors

Reasonable Hypothesis (RH) — Statement of Principles No. 13 of 2021

At least one of the following factors must as a minimum exist before it can be said that a reasonable hypothesis has been raised connecting psoriasis or death from psoriasis with the circumstances of a person's relevant service:

1. (1)
   having an injury to the skin of the affected site or developing a lesion of the affected site within the 30 days before the clinical onset of psoriasis;
2. (2)
   taking a drug from the specified list of drugs for at least the seven days before the clinical onset of psoriasis;

   Note: specified list of drugs is defined in the Schedule 1 - Dictionary.

3. (3)
   taking a drug which is associated in the individual with: (a) the development of psoriasis during drug therapy; and (b) the improvement of psoriasis within two months of discontinuing or tapering drug therapy; where taking the drug continued for at least the seven days before the clinical onset of psoriasis;
4. (4)
   withdrawing from tumour necrosis factor-α inhibitor treatment in the six months before the clinical onset of psoriasis;
5. (5)
   withdrawing from systemic glucocorticoids, moderate potency topical glucocorticoids or high potency topical glucocorticoids in the 30 days before the clinical onset of psoriasis;

   Note: moderate potency topical glucocorticoids and high potency topical glucocorticoids are defined in the Schedule 1 - Dictionary.

6. (6)
   consuming an average of at least 200 grams of alcohol per week for at least the one year before the clinical onset of psoriasis;

   Note: Alcohol consumption is calculated utilising the Australian Standard of ten grams of alcohol per standard alcoholic drink.

7. (7)
   experiencing a category 1A stressor within the six months before the clinical onset of psoriasis;

   Note: category 1A stressor is defined in the Schedule 1 - Dictionary.

8. (8)
   experiencing a category 1B stressor within the six months before the clinical onset of psoriasis;

   Note: category 1B stressor is defined in the Schedule 1 - Dictionary.

9. (9)
   experiencing a category 2 stressor within the six months before the clinical onset of psoriasis;

   Note: A category 2 stressor can arise in a variety of circumstances connected with service. Such circumstances can arise during the course of service, as a result of separation from service and the conditions associated with that separation, and in the transition to civilian life in the years following separation.

   Note: category 2 stressor is defined in the Schedule 1 - Dictionary.

10. (10)
    having a Streptococcus pyogenes infection of the pharynx, tonsils or skin within the 30 days before the clinical onset of psoriasis;
11. (11)
    having infection with human immunodeficiency virus before the clinical onset of psoriasis;
12. (12)
    having smoked at least five pack-years of tobacco products before the clinical onset of psoriasis;

    Note: pack-year of tobacco products is defined in the Schedule 1 - Dictionary.

13. (13)
    being exposed to second-hand smoke for at least 5,000 hours before the clinical onset of psoriasis;

    Note: being exposed to second-hand smoke is defined in the Schedule 1 - Dictionary.

14. (14)
    being overweight or obese for at least five years before the clinical onset of psoriasis;

    Note: being overweight or obese is defined in the Schedule 1 - Dictionary.

15. (15)
    for impetigo herpetiformis only, being pregnant within the six weeks before the clinical onset of impetigo herpetiformis;

    Note: impetigo herpetiformis is defined in the Schedule 1 - Dictionary.

16. (16)
    having an injury to the skin of the affected site or developing a lesion of the affected site within the 30 days before the clinical worsening of psoriasis;
17. (17)
    taking a drug from the specified list of drugs for at least the seven days before the clinical worsening of psoriasis;

    Note: specified list of drugs is defined in the Schedule 1 - Dictionary.

18. (18)
    taking a drug which is associated in the individual with: (a) the worsening of psoriasis during drug therapy; and (b) the improvement of psoriasis within two months of discontinuing or tapering drug therapy; where taking the drug continued for at least the seven days before the clinical worsening of psoriasis;
19. (19)
    withdrawing from tumour necrosis factor-α inhibitor treatment in the six months before the clinical worsening of psoriasis;
20. (20)
    withdrawing from systemic glucocorticoids, moderate potency topical glucocorticoids or high potency topical glucocorticoids in the 30 days before the clinical worsening of psoriasis;

    Note: moderate potency topical glucocorticoids and high potency topical glucocorticoids are defined in the Schedule 1 - Dictionary.

21. (21)
    consuming an average of at least 200 grams of alcohol per week for at least the one year before the clinical worsening of psoriasis;

    Note: Alcohol consumption is calculated utilising the Australian Standard of ten grams of alcohol per standard alcoholic drink.

22. (22)
    experiencing a category 1A stressor within the six months before the clinical worsening of psoriasis;

    Note: category 1A stressor is defined in the Schedule 1 - Dictionary.

23. (23)
    experiencing a category 1B stressor within the six months before the clinical worsening of psoriasis;

    Note: category 1B stressor is defined in the Schedule 1 - Dictionary.

24. (24)
    experiencing a category 2 stressor within the six months before the clinical worsening of psoriasis;

    Note: A category 2 stressor can arise in a variety of circumstances connected with service. Such circumstances can arise during the course of service, as a result of separation from service and the conditions associated with that separation, and in the transition to civilian life in the years following separation.

    Note: category 2 stressor is defined in the Schedule 1 - Dictionary.

25. (25)
    having a Streptococcus pyogenes infection of the pharynx, tonsils or skin within the 30 days before the clinical worsening of psoriasis;
26. (26)
    having infection with human immunodeficiency virus before the clinical worsening of psoriasis;
27. (27)
    having smoked at least five pack-years of tobacco products before the clinical worsening of psoriasis;

    Note: pack-year of tobacco products is defined in the Schedule 1 - Dictionary.

28. (28)
    being exposed to second-hand smoke for at least 5,000 hours before the clinical worsening of psoriasis;

    Note: being exposed to second-hand smoke is defined in the Schedule 1 - Dictionary.

29. (29)
    being overweight or obese for at least five years before the clinical worsening of psoriasis;

    Note: being overweight or obese is defined in the Schedule 1 - Dictionary.

30. (30)
    inability to obtain appropriate clinical management for psoriasis;

Aggravation-only factors: the factors in subsections 9(16) to 9(30) apply only to material contribution to, or aggravation of, the condition where it was suffered or contracted before or during (but did not arise out of) the person’s relevant service.