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Allergologia et Immunopathologia
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Inicio Allergologia et Immunopathologia Severity scoring of atopic dermatitis: a comparison of two scoring systems
Journal Information
Vol. 36. Num. 4.August 2008
Pages 185-243
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Vol. 36. Num. 4.August 2008
Pages 185-243
DOI: 10.1016/S0301-0546(08)72551-5
Severity scoring of atopic dermatitis: a comparison of two scoring systems
V.E.V. Rullo
Corresponding author

Correspondence: Vera E.V. Rullo Rua dos Otonis 725. 04025-002 São Paulo. Brazil Phone/fax: 55 11 55791590.
, A. Segato, A. Kirsh, D. Sole
Division of Allergy, Clinical Immunology, and Rheumatology. Department of Pediatrics. Federal University of São Paulo-Escola Paulista de Medicina. São Paulo. Brasil
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Tables (4)
Tabla I. Comparison between mean Eczema Area and Severity Index (EASI) scores (total and segments; range) obtained in two evaluations 4weeks apart by two physicians (A and B)
Tabla II. Comparison between mean Scoring Atopic Dermatitis (SCORAD) scores (criteria and total; range) obtained by two physicians (A e B) in two evaluations 4weeks apart
Tabla III. Correlation between Scoring Atopic Dermatitis (SCORAD) and Eczema Area and Severity Index (EASI) scores obtained by two physicians in two evaluations 4week apart
Tabla IV. Features of children included in this study
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Atopic dermatitis (AD) is a chronic inflammatory pruritic skin heterogeneous disease, which does not have an objective tool able to permit comparison between patients and to monitor changes due to a specific treatment. Several assessment methods have been developed to evaluate the AD.


The aim of this study was to investigate the agreement between two observers in the assessment of the severity of AD applying SCORAD index and EASI in infants and young children with AD. The variations of parameters that compose each score, as well as the inter-observer variation for both scores, were also studied.


We evaluated 42 infants and young children admitted and followed in a paediatric allergy centre (UNIFESP-EPM). All children met the diagnostic criteria for clinical AD established by Hanifin and Rajka. Two investigators graded the severity of AD, applying the SCORAD index and EASI. The two scoring systems assessed the variation between baseline evaluation and one month after treatment.


Significant correlations were observed comparing both scores for each physician and each evaluation. There were no differences between the mean SCORAD and EASI scores for each physician, in the two evaluations. There was a significant decrease in the mean total SCORAD and EASI score and its components, except for the item Upper Extremities EASI


Both scoring systems for AD are valid, reproducible and responsive in monitoring AD patients. Further studies will be necessary to investigate the development of AD and the best evaluation. SCORAD showed itself to be an excellent score to detect the development of AD, whereas the EASI are suitable to follow up in drug-effect studies of AD for research purposes.

Key words:
Atopic dermatitis
Scoring system


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