Eczema Area and Severity Index

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Eczema Area and Severity Index
Purposemeasurement of severity of atopic dermatitis
Based on Psoriasis Area and Severity Index

The Eczema Area and Severity Index (EASI) is a validated tool for the measurement of severity of atopic dermatitis. It ranges from 0 (no disease) to 72 (maximal disease). [1] [2] The EASI was developed in 1998 by modifying the Psoriasis Area and Severity Index (PASI), a widely accepted scoring system for psoriasis. [3]

Contents

EASI is one of the core outcome instruments recommended to be included in all clinical trials on atopic dermatitis by the Harmonising Outcome Measures for Eczema (HOME) group. [4]

Calculation

Similar to the PASI, the EASI divides the body into four regions. The head and neck (H) are assigned 10% of the body surface area, the upper limbs (U) 20%, the trunk (T) 30%, and lower limbs (L) 40%. [5] The area of involvement is determined visually for each region, and the percentage of skin affected is converted into an area score as follows:

  1. 0% of involved area
  2. 1-9% of involved area
  3. 10–29% of involved area
  4. 30–49% of involved area
  5. 50–69% of involved area
  6. 70–89% of involved area
  7. 90–100% of involved area

A severity score is then calculated for each region. The total severity score for a region is equal to the sum of the intensity scores for four clinical signs, erythema, edema/papulation, excoriation, and lichenification. The average intensity for each sign is assigned a score of 0 to 3, with 0 being none and 3 being severe.

The region score is then calculated by multiplying the severity score for each region by the corresponding area score and area multiplier (0.1 for head, 0.2 for upper limbs, 0.3 for trunk, and 0.4 for lower limbs).

The final EASI score is the sum of the four regional scores.

See also

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References

  1. Hanifin, J. M.; Thurston, M.; Omoto, M.; Cherill, R.; Tofte, S. J.; Graeber, M. (2001). "The eczema area and severity index (EASI): assessment of reliability in atopic dermatitis. EASI Evaluator Group". Experimental Dermatology. 10 (1): 11–18. doi:10.1034/j.1600-0625.2001.100102.x. PMID   11168575. S2CID   25864663.
  2. Leshem, Y. A.; Hajar, T; Hanifin, J. M.; Simpson, E. L. (2015). "What the Eczema Area and Severity Index score tells us about the severity of atopic dermatitis: An interpretability study". British Journal of Dermatology. 172 (5): 1353–1357. doi:10.1111/bjd.13662. PMID   25580670. S2CID   207072864.
  3. Tofte, Susan J.; Graeber, Michael; Cherill, Robert J.; Omoto, Mitsuyoshi; Thurston, Mark; Hanifin, Jon (1 September 1998). "Eczema area and severity index (EASI): A new tool to evaluate atopic dermatitis". Journal of the European Academy of Dermatology and Venereology. 11 (Supplement 2): S197. doi:10.1016/S0926-9959(98)95291-6. ISSN   0926-9959. S2CID   72210425.
  4. Schmitt, Jochen; Spuls, Phyllis I.; Thomas, Kim S.; Simpson, Eric; Furue, Masutaka; Deckert, Stefanie; Dohil, Magdalene; Apfelbacher, Christian; Singh, Jasvinder A.; Chalmers, Joanne; Williams, Hywel C. (October 2014). "The Harmonising Outcome Measures for Eczema (HOME) statement to assess clinical signs of atopic eczema in trials". Journal of Allergy and Clinical Immunology. 134 (4): 800–807. doi: 10.1016/j.jaci.2014.07.043 . ISSN   0091-6749. PMID   25282560.
  5. Hanifin, Jon M.; Baghoomian, Wenelia; Grinich, Erin; Leshem, Yael A.; Jacobson, Michael; Simpson, Eric Lawrence (2022). "The Eczema Area and Severity Index—A Practical Guide". Dermatitis. 33 (3): 187–192. doi:10.1097/DER.0000000000000895. PMC   9154300 . PMID   35594457.