ATOPIC DERMATITIS CLINICAL TOOLS
Welcome to the Clinical Tools section of the Eczema Hub! This section is designed for clinicians to find established, validated, and reliable clinical tools for your practice and your patients. These tools are used to support the measurement, diagnosis, and management of atopic dermatitis. It is important to understand that no single tool is sufficient to characterize the severity of atopic dermatitis and it is recommended that a combination of these tools be used to achieve a balance and holistic representation (Narla & Silverberg, 2024).​​
​​​​As of recent, the most commonly used tools by clinicians for assessing and measuring the severity of AD are the Eczema Area and Severity Index (EASI), the Scoring Atopic Dermatitis (SCORAD), the Patient-Oriented Eczema measure (POEM), the Investigator Global Assessment for Atopic Dermatitis (IGA), the Pruritus Numerical Rating Scale (PRNS), and the Dermatology Life Quality Index (Maintz et al., 2021, Narla & Silverberg, 2024).
Other tools that can be used in AD assessment and measurement that are not mentioned on this webpage can be found by clicking here and exploring appendix four (pages 117-124) of this Canadian source.
Eczema Area and Severity Index (EASI)
The Eczema Area and Severity Index (EASI) is a validated and consistent scale used to assess the severity and extent of atopic dermatitis (AD). It is recommended as the core outcome measure for the clinical signs of eczema. The EASI assesses the severity of four characteristics of AD including erythema, infiltration and/or papulation, excoriations, and lichenification. EASI scores range from 0 to 72 points, where higher scores indicate greater severity.
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For more comprehensive information on this tool from a Canadian Source, click here and explore appendix four (pages 117-124). Despite not being a recent publication, click here for the best and most accurate access to this tool with diagrams, examples on how to use the tool and information on the original publication.​​
Eczema Area and Severity Index (EASI) (Tofte et al., 1998, as cited in Honari, 2017).
Severity Scoring of Atopic Dermatitis (SCORAD)
The Severity Scoring of Atopic Dermatitis (SCORAD) is a valid and reliable tool used to objectively evaluate the extent and severity of AD by looking at three components, the affected body, severity of clinical signs, and symptoms. The severity of six specific symptoms including redness, swelling, oozing and/or crusting, excoriation, skin thickening and/or lichenification, and dryness are assessed using a four-point scale. The SCORAD is later calculated based on the three components of AD and the maximum score achievable is 103 with a higher score indicating a poorer and more severe condition.​
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For more comprehensive information on this tool from a Canadian Source, click here and explore appendix four (pages 117-124). Despite not being recent, click here for the best and most accurate access to this tool with diagrams, information on how to use this tool, and information on the original publication.​​​
Severity Scroing of Atopic Dermatitis (SCORAD), (Severity scoring of atopic dermatitis: the SCORAD index. consensus report of the european task force on atopic dermatitis, 1993, as cited in Honari, 2017).
Patient-Oriented Eczema Measure (POEM)
The Pateint-Oriented Eczema Measurement (POEM) tool is a seven-item questionnaire used to assess disease symptoms in children and adults. Based on the frequency of occurrence during the past week, seven items including dryness, itching, flaking, cracking, sleep loss, bleeding, and weeping are assessed on a five-point scale. The maximum POEM score is 28. A higher POEM score indicates a poorer quality of life and more severe eczema.
For more comprehensive information on this tool from a Canadian Source, click here and explore appendix four (pages 117-124). Despite not being recent, click here for the best and most accurate access to this tool with descriptions, information on how to use the tool, and information on the original publication.​​​
Patient-Oriented Eczema Measure (POEM) (Charman et al., 2004, as cited in Honari, 2017).
Investigator's Global Assessment (IGA)
Investigator's Global Assessment (IGA), (Copyright ©2017 Eli Lilly and Company – Used with the permission of Eli Lilly and Company under a Creative Commons Attribution-NoDerivatives 4.0 International License - https://creativecommons.org/licenses/by-nd/4.0/).
The Investigator's Global Assessment (IGA) is a validated five-point assessment scale that provides a global clinical assessment of AD. On this scale, a score of “0” indicates clear, and a score of “4” indicates severe AD.
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​It is important to note that, although this tool in commonly used in clinical trials as it is a clinician-reported outcome measure, a more recent source from this year, found by clicking here, states this tool is feasible in clinical practice.​
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For more comprehensive information on this tool from a Canadian Source, please click here and explore appendix four (pages 117-124). For access to this tool please click here.
Pruritus Numerical Rating Scale (PRNS)
The Pruritus Numerical Rating Scale (PRNS) is a valid and reliable tool used by patients to report the intensity of their itch during a daily recall period. Patients are asked to rate their average and maximum intensity of itch experienced during the past 24 hours based on a scale of 0 (no itch) to 10 (worst itch imaginable)​​
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For more comprehensive information on this tool from a Canadian Source, please click here and explore appendix four (pages 117-124). To access the validated version of this tool please click here.
Dermatology Life Quality Index &
Children's Dermatology Life Quality Index
(Copyright ©1992 Dermatology Life Quality Index. A., Y, Finlay, G., K, Khan).
(Copyright ©1993 Children's Dermatology Life Quality Index. M., S. Lewis-Jones, A., Y. Finlay. June 1993 Illustrations ©Media Resources Centre, UWCM. Dec 1996).
The Dermatology Life Quality Index and Children's Dermatology Life Quality Index are two widely used dermatology-specific quality-of-life instruments. They both employ a 10-item questionnaire that assesses aspects of AD that can affect quality of life. ​
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For more comprehensive information on these tools from a Canadian Source, please click here and explore appendix four (pages 117-124). For access to these tools please click here and navigate the website to respective categories.