The Self-Administered Eczema Area and Severity Index in Children with Moderate to Severe Atopic Dermatitis: Better Estimation of AD Body Surface Area Than Severity

Abstract

The Self-Administered Eczema Area and Severity Index (SA-EASI) is one of the few patient based atopic dermatitis (AD) disease activity scores and was found to be highly correlated with the EASI. Correlation with other frequently used scoring methods has not been investigated. The aim of this study was to evaluate the relation of the SA-EASI with two physician-based disease activity scores (objective SCORAD and SASSAD score) and with a serum marker for AD (Thymus and Activation-Regulated Cytokine [TARC]) in children with AD. Sixty children with moderate to severe AD were included. The SA-EASI was completed by caregivers, and the objective SCORAD and SASSAD scores were measured successively on the same day by a trained investigator. Blood for serum TARC measurement was drawn. The correlation between the SA-EASI and the objective SCORAD was high (ρ = 0.61, p = <0.001), mainly based on high correlation between the body surface area (BSA) measurements of both scores (ρ = 0.50, p = <0.001). The correlation with the SASSAD score (only severity measurement) was 0.43 (p = <0.001). The correlation with serum TARC levels was 0.46; p = <0.001, mainly based on the BSA score of the SA-EASI (ρ = 0.42, p = <0.001). Parents may have more difficulty in scoring severity of AD than scoring BSA involved. Educating parents in severity scoring of AD may improve agreement of the SA-EASI and the objective SCORAD, TARC, and SASSAD score. Additional use of the SA-EASI in routine clinical practice or in trials may then facilitate more frequent but still accurate assessment of AD.

Utility of serum thymus and activation-regulated chemokine as a biomarker for monitoring of atopic dermatitis severity

“…This variation in sTARC levels may explain the intermediate strength correlation between sTARC and SASSAD or BSA as shown previously. 9,19,[20][21][22][23][24][25][26][27][28] In addition, we analyzed the relation between disease severity and sTARC at baseline, using the 3 categories of SASSAD (mild, moderate, severe) and sTARC (low, intermediate, high). sTARC reflects indeed the disease severity in the majority of patients.…”

“…[9][10][11][12] Previously reported correlation coefficients between sTARC and disease severity scores (mainly SCORAD or SASSAD) varied between 0.39 and 0.99, 9,[19][20][21][22][23][24][25][26][27][28] but were investigated in small study populations 9,20,21,[23][24][25][26]29 predominantly in children. 20,[23][24][25][26][27][28] Only a few small studies investigated sTARC in AD longitudinally. 9,19,20,22,29,30 The aim of the current study was to validate sTARC as a biomarker for monitoring AD severity in adult patients in daily practice.…”

Warm, Humid, and High Sun Exposure Climates Are Associated with Poorly Controlled Eczema: PEER (Pediatric Eczema Elective Registry) Cohort, 2004–2012

“…The patient self-described outcome of disease control is a well-validated measure of eczema severity that correlates with Eczema Area and Severity Index (EASI) scores. (Barbier et al , 2004; Eichenfield et al , 2002; Hanifin et al , 2001; Housman et al , 2002; Kapoor et al , 2009; Kapoor et al , 2008; Kapp et al , 2002; Schmitt et al , 2007; van Velsen et al , 2010; Wahn et al , 2002)…”

Severe Chronic Allergic (and Related) Diseases: A Uniform Approach – A MeDALL – GA²LEN – ARIA Position Paper

“…Recently, a patient-oriented version of SCORAD (PO-SCORAD) was proposed and validated, allowing the estimation of severity to be made by the patients themselves or the caregivers of affected children [102]. These scoring systems only provide a snapshot of the current disease situation for a given patient at a defined time point [103] and should be more appropriately considered as control tests.…”