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Severity strata for Eczema Area and Severity Index (EASI), modified EASI, Scoring Atopic Dermatitis (SCORAD), objective SCORAD, Atopic Dermatitis Severity Index and body surface area in adolescents and adults with atopic dermatitis.
Br J Dermatol. 2017 Nov; 177(5):1316-1321.BJ

Abstract

BACKGROUND

Scoring systems for assessing the signs of atopic dermatitis (AD) are complex and difficult to interpret. Severity strata are helpful to interpret these assessments properly.

OBJECTIVES

To confirm previously reported strata for the Eczema Area and Severity Index (EASI), Scoring Atopic Dermatitis (SCORAD) and the objective component of SCORAD (oSCORAD), and to develop strata for the modified EASI (mEASI), Atopic Dermatitis Severity Index (ADSI) and body surface area (BSA) for use in adults with AD.

METHODS

Skin examination was performed in 673 adolescents and adults (age ≥ 13 years) with diagnosed AD, in a dermatology practice setting. Strata were selected using an anchoring approach based on a four-point Investigator's Global Assessment of severity (clear of active skin lesions, mild, moderate or severe disease).

RESULTS

We determined potential severity strata for EASI (0 clear, 0·1-5·9 mild, 6·0-22·9 moderate, 23·0-72 severe; κ = 0·69), mEASI (0-0·9 clear, 1-8·9 mild, 9·0-29·9 moderate, 30·0-90 severe; κ = 0·71), oSCORAD (0-7·9 clear, 8·0-23·9 mild, 24·0-37·9 moderate, 38·0-83 severe; κ = 0·70), SCORAD (0-9·9 clear, 10·0-28·9 mild, 29·0-48·9 moderate, 49·0-103 severe; κ = 0·68), ADSI (0-1·9 clear, 2-5·9 mild, 6·0-8·9 moderate, 9·0-15 severe; κ = 0·55) and BSA (0 clear, 0·1-15·9 mild, 16·0-39·9 moderate, 40·0-100 severe; κ = 0·66). oSCORAD values > 0 were found in clear skin due to the presence of xerosis, which is scored in oSCORAD. Similarly, SCORAD values > 0 were found in clear skin due to the scoring of xerosis, pruritus and sleeplessness. Similarly, mEASI and ADSI scores > 0 occurred in patients with clear skin due to scoring of pruritus.

CONCLUSIONS

We recommend using these strata for interpretation of their respective measures in clinical trials of AD. There are important differences between the five assessments, which profoundly impact the interpretation of their scores.

Authors+Show Affiliations

Department of Dermatology, Feinberg School of Medicine at Northwestern University, Chicago, IL, 60611, U.S.A.Department of Dermatology, Feinberg School of Medicine at Northwestern University, Chicago, IL, 60611, U.S.A.Department of Dermatology, Feinberg School of Medicine at Northwestern University, Chicago, IL, 60611, U.S.A.Department of Dermatology, Feinberg School of Medicine at Northwestern University, Chicago, IL, 60611, U.S.A.Department of Dermatology, Feinberg School of Medicine at Northwestern University, Chicago, IL, 60611, U.S.A.Northwestern Medicine Multidisciplinary Eczema Center, Chicago, IL, U.S.A.Department of Dermatology, Feinberg School of Medicine at Northwestern University, Chicago, IL, 60611, U.S.A.Department of Dermatology, Feinberg School of Medicine at Northwestern University, Chicago, IL, 60611, U.S.A.Department of Dermatology, Feinberg School of Medicine at Northwestern University, Chicago, IL, 60611, U.S.A. Northwestern Medicine Multidisciplinary Eczema Center, Chicago, IL, U.S.A.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

28485036

Citation

Chopra, R, et al. "Severity Strata for Eczema Area and Severity Index (EASI), Modified EASI, Scoring Atopic Dermatitis (SCORAD), Objective SCORAD, Atopic Dermatitis Severity Index and Body Surface Area in Adolescents and Adults With Atopic Dermatitis." The British Journal of Dermatology, vol. 177, no. 5, 2017, pp. 1316-1321.
Chopra R, Vakharia PP, Sacotte R, et al. Severity strata for Eczema Area and Severity Index (EASI), modified EASI, Scoring Atopic Dermatitis (SCORAD), objective SCORAD, Atopic Dermatitis Severity Index and body surface area in adolescents and adults with atopic dermatitis. Br J Dermatol. 2017;177(5):1316-1321.
Chopra, R., Vakharia, P. P., Sacotte, R., Patel, N., Immaneni, S., White, T., Kantor, R., Hsu, D. Y., & Silverberg, J. I. (2017). Severity strata for Eczema Area and Severity Index (EASI), modified EASI, Scoring Atopic Dermatitis (SCORAD), objective SCORAD, Atopic Dermatitis Severity Index and body surface area in adolescents and adults with atopic dermatitis. The British Journal of Dermatology, 177(5), 1316-1321. https://doi.org/10.1111/bjd.15641
Chopra R, et al. Severity Strata for Eczema Area and Severity Index (EASI), Modified EASI, Scoring Atopic Dermatitis (SCORAD), Objective SCORAD, Atopic Dermatitis Severity Index and Body Surface Area in Adolescents and Adults With Atopic Dermatitis. Br J Dermatol. 2017;177(5):1316-1321. PubMed PMID: 28485036.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Severity strata for Eczema Area and Severity Index (EASI), modified EASI, Scoring Atopic Dermatitis (SCORAD), objective SCORAD, Atopic Dermatitis Severity Index and body surface area in adolescents and adults with atopic dermatitis. AU - Chopra,R, AU - Vakharia,P P, AU - Sacotte,R, AU - Patel,N, AU - Immaneni,S, AU - White,T, AU - Kantor,R, AU - Hsu,D Y, AU - Silverberg,J I, Y1 - 2017/10/01/ PY - 2017/04/27/accepted PY - 2017/5/10/pubmed PY - 2018/8/29/medline PY - 2017/5/10/entrez SP - 1316 EP - 1321 JF - The British journal of dermatology JO - Br J Dermatol VL - 177 IS - 5 N2 - BACKGROUND: Scoring systems for assessing the signs of atopic dermatitis (AD) are complex and difficult to interpret. Severity strata are helpful to interpret these assessments properly. OBJECTIVES: To confirm previously reported strata for the Eczema Area and Severity Index (EASI), Scoring Atopic Dermatitis (SCORAD) and the objective component of SCORAD (oSCORAD), and to develop strata for the modified EASI (mEASI), Atopic Dermatitis Severity Index (ADSI) and body surface area (BSA) for use in adults with AD. METHODS: Skin examination was performed in 673 adolescents and adults (age ≥ 13 years) with diagnosed AD, in a dermatology practice setting. Strata were selected using an anchoring approach based on a four-point Investigator's Global Assessment of severity (clear of active skin lesions, mild, moderate or severe disease). RESULTS: We determined potential severity strata for EASI (0 clear, 0·1-5·9 mild, 6·0-22·9 moderate, 23·0-72 severe; κ = 0·69), mEASI (0-0·9 clear, 1-8·9 mild, 9·0-29·9 moderate, 30·0-90 severe; κ = 0·71), oSCORAD (0-7·9 clear, 8·0-23·9 mild, 24·0-37·9 moderate, 38·0-83 severe; κ = 0·70), SCORAD (0-9·9 clear, 10·0-28·9 mild, 29·0-48·9 moderate, 49·0-103 severe; κ = 0·68), ADSI (0-1·9 clear, 2-5·9 mild, 6·0-8·9 moderate, 9·0-15 severe; κ = 0·55) and BSA (0 clear, 0·1-15·9 mild, 16·0-39·9 moderate, 40·0-100 severe; κ = 0·66). oSCORAD values > 0 were found in clear skin due to the presence of xerosis, which is scored in oSCORAD. Similarly, SCORAD values > 0 were found in clear skin due to the scoring of xerosis, pruritus and sleeplessness. Similarly, mEASI and ADSI scores > 0 occurred in patients with clear skin due to scoring of pruritus. CONCLUSIONS: We recommend using these strata for interpretation of their respective measures in clinical trials of AD. There are important differences between the five assessments, which profoundly impact the interpretation of their scores. SN - 1365-2133 UR - https://www.unboundmedicine.com/medline/citation/28485036/Severity_strata_for_Eczema_Area_and_Severity_Index__EASI__modified_EASI_Scoring_Atopic_Dermatitis__SCORAD__objective_SCORAD_Atopic_Dermatitis_Severity_Index_and_body_surface_area_in_adolescents_and_adults_with_atopic_dermatitis_ L2 - https://doi.org/10.1111/bjd.15641 DB - PRIME DP - Unbound Medicine ER -