Clinical Validation and Guidelines for the SCORAD Index: Consensus Report of the European Task Force on Atopic Dermatitis

Abstract

Background: We have previously reported how the SCORAD index was designed. This cumulative index combines objective (extent and intensity of lesions) and subjective (daytime pruritus and sleep loss) criteria. Aims: To study interobserver variability in scoring for objective SCORAD criteria and to optimize the scoring guidelines. Material and Methods: Three scoring sessions were organized in 1993-1994 in Hamburg, Bordeaux and Rotterdam totalizing 19 patients (14 children and 5 adults) and 23 physicians, among whom 12 participated in at least 2 scoring sessions; 169 evaluation sheets have been processed using the SCORAD File Marker Pro software. At each session, total body photographs and close-up views were taken of each patient, and this material was reviewed at the final evaluation. Results: The extent of lesions according to the rule of nines showed interobserver variability mostly for patients with lesions of moderate intensity involving 20–60% of body surface. Intensity items were scored with more consistency overall, but variations subsided especially for oozing/crusts and lichenifications. Low and high scorer profiles and the benefit of training were noted. Conclusions: This study has allowed to optimize clinical scoring using the SCORAD system. A proposal has been made to grade the severity of atopic dermatitis according to objective criteria in three groups for inclusion in clinical trials. The SCORAD index remains the major criterion for follow-up in trials.

Prebiotic‐supplemented partially hydrolysed cow's milk formula for the prevention of eczema in high‐risk infants: a randomized controlled trial

“…Stool frequency and consistency and gastrointestinal tract symptoms were assessed by parent‐completed questionnaires at all study visits using Likert scales 16. Blood was collected from randomized participants at 6 months for immune assessment.…”

The Efficacy and Safety of Long-term Oral Cyclosporine Treatment for Patients with Atopic Dermatitis

“…The age and gender, the changes in the objective SCORAD scores, the dose and duration of CsA treatment, the laboratory findings and the blood pressure were reviewed. The severity of disease was evaluated with the objective SCORAD score 16,17 . The difference between the classic SCORAD and the objective SCORAD is described in Table 1.…”

“…After the skin lesions subsided, the patients visited our clinic every month. The severity of symptoms was divided into 3 groups according to the objective SCORAD score: mild was lower than 15, moderate was from 15 to 40 and severe was more than 40 16 . The objective SCORAD scoring was measured by dermatologists who had been trained for the SCORAD scoring system to minimize the inter-evaluator variance.…”

Assessment of the severity of atopic dermatitis

“…objective SCORAD), w któ-rym wyeliminowano ocenę objawów subiektywnych przez pacjenta. Maksymalny wynik tej skali wynosi 83 punkty, przy czym w najcięższych przypadkach można dodać 10 punktów za zmiany szpecące lub ograniczające funkcjonowanie chorego [13]. Nasilenie choroby ocenia się jako łagodne przy wyniku poniżej 15 punktów, umiarkowane pomiędzy 15 a 40 punktów i ciężkie powyżej 40 punktów, czyli inaczej niż w przypadku SCORAD [12].…”