Background. Assessment methods for atopic dermatitis (AD) are not standardized, and therapeutic studies are difficult to interpret. Aims. To obtain a consensus on assessment methods in AD and to use a statistical method to develop a composite severity index.Methods. Consensus definitions were given for items used in the scoring system (extent, intensity, subjective) and illustrated for intensity items. Slides were reviewed to address within and between-observer variability by a group of 10 trained clinicians, and data were statistically evaluated with a two way analysis of variance. Two variants of an assessment system were compared in 88 patients at 5 different institutions. Data were analyzed using principal-component analysis. Results. For 5 intensity items studied (erythema, edema/papulation, oozing/crusts, excoriations, lichenification), within- and between-observer variability was good overall, except for edema/papulation which was difficult to assess with slides. In the series of 88 patients, principal-component analysis allowed to extract two unrelated components: the first one accounting for 33% of total variance was interpreted as a ‘severity’ component; the second one, accounting for 18% of variance, was interpreted as a ‘profile’ component distinguishing patients with mostly erythema and subjective symptoms and those with mostly lichenification and dryness and lower subjective symptoms. Of the two evaluation systems used, the one using the rule of nine to assess extent was found more workable than the one using a distribution × intensity product. A scoring index (SCORAD) combining extent, severity and subjective symptoms was mathematically derived from the first system and showed a normal distribution of the population studied. Conclusion. The final choice for the evaluation system was mostly made based on simplicity and easy routine use in outpatient clinics. Based on mathematical appreciation of weights of the items used in the assessment of AD, extent and subjective symptoms account for around 20% each of the total score, intensity items representing 60%. The so-designed composite index SCORAD needs to be further tested in clinical trials.

Over 21 years, in the group studied, the total area of the detected objects remains quite constant. Only the distribution between small and large detected objects (microrelief features and wrinkles, respectively) is modified.

This new device appears to be a very convenient way for characterizing the properties of the skin surface. With regard to hydration, it usefully provides both the average value and the hydration chart of the investigated skin zones.

Background: There are few objective descriptions of the age-related changes taking place on the lips and perioral skin. This zone, however, has great importance in relational functions. Objectives: To describe quantitatively the age-related changes in dimension of the lips and the appearance of the perioral wrinkles, to revisit, thanks to a new method, the pattern of the lip furrows, to compare the hydration states of the upper and lower lips. Methods: On 100 women, we clinically scored wrinkles, dryness of the lips and the general photoageing of the facial skin. We used a Corneometer^® for measuring dryness of the lips and SkinChip^® for recording lip surface patterns. Results: The upper lip is more hydrated than the lower one, and there is no correlation between lip capacitance and the clinical score of lip dryness. The surface pattern can be classified into 3 main groups with no relation to age. Wrinkle number and visibility are linearly related to age, becoming visible during the fifth decade. The intercommissural distance increases with age, whereas lip height decreases. Conclusions: Both lips are different in terms of dryness. Inversely to their surface pattern, their dimensions are markedly changed with age. The time of apparition of vertical wrinkles suggests a possible influence of hormones.

Numerous factors can modify the visibility or the actual dimensions of the skin microrelief and wrinkles. To quantify these changes, several methods, including clinical and non-invasive ones, have been proposed. This article reviews the advantages et drawbacks of all of them and lists some experimental recommendations to make the results of studies using these methods, more reliable.