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Protocol - Eczema

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Description:

The Eczema Area and Severity Index© (EASI) is a tool to determine the level of severity and extent of atopic eczema. The EASI© is completed by a physician or trained assistant observing four regions of the respondent's body for the presence of four features of eczema. Each feature is given a score and the scores are used to determine the severity of the respondent's eczema. Full and half scores are allowed. The EASI© contains detailed scoring instructions.

Protocol:

The Eczema Area and Severity Index©

Intensity

A representative area of eczema is selected for each body region. The intensity of redness (erythema), thickness (induration, papulation, oedema), scratching (excoriation) and lichenification (lined skin) of the eczema is assessed as none (0), mild (1), moderate (2), and severe (3). Half scores are allowed.

Eczema: severity scoring

Intensity

Absent

Mild

Moderate

Severe

Redness Score 0
Score 0
Score 1
Score 1
Score 2
Score 2
Score 3
Score 3
Thickness Score 0
Score 0
Score 1
Score 1
Score 2
Score 2
Score 3
Score 3
Scratching Score 0
Score 0
Score 1
Score 1
Score 2
Score 2
Score 3
Score 3
Lichenification Score 0
Score 0
Score 1
Score 1
Score 2
Score 2
Score 3
Score 3

Calculation for intensity

The four intensity scores are added up for each of the four body regions to give subtotals A1, A2, A3, A4.

Each subtotal is multiplied by the body surface area represented by that region.

  • A1 x 0.1 gives B1 (in children 0–7 years, A1 x 0.2 gives B1)
  • A2 x 0.2 gives B2
  • A3 x 0.3 gives B3
  • A4 x 0.5 gives B4 (in children 0–7 years, A1 x 0.3 gives B1)

Area

The percentage area affected by eczema is evaluated in the four regions of the body. In each region, the area is expressed as nil (0), 1%–9% (1), 10%–29% (2), 30%–49% (3), 50%–69% (4), 70%–89% (5), or 90%–100% (6).

  • Head and neck
  • Upper limbs
  • Trunk
  • Lower limbs

Calculations for area

Each of the body area scores is multiplied by the area affected.

  • B1 x (0 to 6) = C1
  • B2 x (0 to 6) = C2
  • B3 x (0 to 6) = C3
  • B4 x (0 to 6) = C4

Total score

The EASI© score is C1 + C2 + C3 + C4.

The Eczema Area and Severity Index ©2010 the New Zealand Dermatological Society Incorporated (NZDSI). All rights reserved.

Protocol Name from Source:

The Expert Review Panel has not reviewed this measure yet.

Availability:

Publicly available

Personnel and Training Required

If the examiner is not a physician, he or she must be trained and found to be competent (i.e., tested by an expert) in conducting physical examinations for atopic eczema.

Equipment Needs

The interviewer will need a copy of the Eczema Area and Severity Index (EASI)©, which includes the scoring instructions.

Requirements
Requirement CategoryRequired
Major equipment No
Specialized training No
Specialized requirements for biospecimen collection No
Average time of greater than 15 minutes in an unaffected individual No
Mode of Administration

Physical Examination

Life Stage:

Infant, Toddler, Child, Adolescent, Adult, Senior, Pregnancy

Participants:

Lifespan (infants to older adults)

Specific Instructions:

None

Selection Rationale

The Eczema Area and Severity Index (EASI)© was selected because it is a widely used, minimally invasive examination tool that can be completed by a trained research assistant in a few minutes. Additionally, the Eczema Area and Severity Index© has a straightforward scoring method which allows for half scores.

Language

English

Standards
StandardNameIDSource
Common Data Elements (CDE) Skin Eczema Assessment Score 3158234 CDE Browser
Logical Observation Identifiers Names and Codes (LOINC) Eczema proto 62902-2 LOINC
Process and Review

The Expert Review Panel has not reviewed this measure yet.

Source

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.

General References

Schmitt, J., Langan, S., Williams, H. C., & the European Dermato-Epidemiology Network. (2007). What are the best outcome measurements for atopic eczema? A systematic review. Journal of Allergy and Clinical Immunology, 120(6), 1389–1398. Epub 2007 Oct 1. Review.

Beck, L. A., Boguniewicz, M., Hata, T., Schneider, L. C., Hanifin, J., Gallo, R., Paller, A. S., Lieff S., Reese, J., Zaccaro, D., Milgrom, H., Barnes, K. C., & Leung, D. Y. (2009). Phenotype of atopic dermatitis subjects with a history of eczema herpeticum. Journal of Allergy and Clinical Immunology, 124(2), 260–269, 269.e1-7.

Protocol ID:

170301

Variables:
Export Variables
Variable NameVariable IDVariable DescriptionVersiondbGaP Mapping
PX170301_Head_And_Neck_Area_Affected PX170301050000 Head and neck percentage area affected by eczema 4 N/A
PX170301_Head_And_Neck_Lichenification_Score PX170301040000 Head and neck lichenification score 4 N/A
PX170301_Head_And_Neck_Redness_Score PX170301010000 Head and neck redness score 4 N/A
PX170301_Head_And_Neck_Scratching_Score PX170301030000 Head and neck scratching score 4 N/A
PX170301_Head_And_Neck_Thickness_Score PX170301020000 Head and neck thickness score 4 N/A
PX170301_Lower_Limbs_Area_Affected PX170301200000 Lower limbs percentage area affected by eczema 4 N/A
PX170301_Lower_Limbs_Lichenification_Score PX170301190000 Lower limbs lichenification score 4 N/A
PX170301_Lower_Limbs_Redness_Score PX170301160000 Lower limbs redness score 4 N/A
PX170301_Lower_Limbs_Scratching_Score PX170301180000 Lower limbs scratching score 4 N/A
PX170301_Lower_Limbs_Thickness_Score PX170301170000 Lower limbs thickness score 4 N/A
PX170301_Trunk_Area_Affected PX170301150000 Trunk percentage area affected by eczema 4 N/A
PX170301_Trunk_Lichenification_Score PX170301140000 Trunk lichenification score 4 N/A
PX170301_Trunk_Redness_Score PX170301110000 Trunk redness score 4 N/A
PX170301_Trunk_Scratching_Score PX170301130000 Trunk scratching score 4 N/A
PX170301_Trunk_Thickness_Score PX170301120000 Trunk thickness score 4 N/A
PX170301_Upper_Limbs_Area_Affected PX170301100000 Upper limbs percentage area affected by eczema 4 N/A
PX170301_Upper_Limbs_Lichenification_Score PX170301090000 Upper limbs lichenification score 4 N/A
PX170301_Upper_Limbs_Redness_Score PX170301060000 Upper limbs redness score 4 N/A
PX170301_Upper_Limbs_Scratching_Score PX170301080000 Upper limbs scratching score 4 N/A
PX170301_Upper_Limbs_Thickness_Score PX170301070000 Upper limbs thickness score 4 N/A
Research Domain Information
Measure Name:

Eczema

Release Date:

November 12, 2010

Definition

This measure is a physical examination of four areas of the body to determine whether the respondent has atopic eczema and to assess the severity of the disease.

Purpose

This measure can be used to assess the presence and severity of eczema, a type of inflammation or dermatitis of the skin, which affects various populations at any age. It can be associated with asthma, allergies, immunodeficiencies, and other autoimmune diseases such as alopecia areata.

Keywords

eczema, itchy skin, skin inflammation, dermatitis, redness, Eczema Area and Severity Index, EASI