Fast Five Quiz: Severe Atopic Dermatitis in Adults

William D. James, MD


September 09, 2020

Figure 1. Atopic dermatitis.

Disease severity assessment is a guideline-recommended first step in treatment selection and is also useful for monitoring treatment response. According to the Atopic Dermatitis Clinical Guideline of the American Academy of Dermatology (AAD), 28 tools for the assessment of disease severity have been developed, but a gold standard has not yet emerged. The SCORAD index, the EASI score, and the Patient Oriented Eczema Measure (POEM) severity scale have all been adequately tested and validated; their use in clinical practice may be considered when feasible.

The SCORAD index and EASI are chiefly used in clinical trials and may be too time-consuming for use in routine clinical practice. The POEM and Patient-Oriented SCORAD (PO-SCORAD) index are validated, patient-reported measures that are faster and easier to use, but they may be less accurate. Clinicians should consider the strengths and weaknesses of the available tools when choosing which to use in practice.

Objective clinician estimates of disease extent and severity are used for the EASI scale, whereas the SCORAD index uses both clinician estimates of disease extent and severity and subjective patient assessment of itch and sleep loss to determine severity.

The POEM index was developed specifically to assess disease severity from the patient's perspective.

Learn more about the assessment of atopic dermatitis severity.


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