Protocol - Eczema
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 respondents 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 respondents eczema. Full and half scores are allowed. The EASI© contains detailed scoring instructions.
Specific Instructions
None
Availability
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 1 |  Score 2 |  Score 3 |
| Thickness |  Score 0 |  Score 1 |  Score 2 |  Score 3 |
| Scratching |  Score 0 |  Score 1 |  Score 2 |  Score 3 |
| Lichenification |  Score 0 |  Score 1 |  Score 2 |  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.
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 Category | Required |
|---|---|
| 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
Lifestage
Infant, Toddler, Child, Adolescent, Adult, Senior, Pregnancy
Participants
Lifespan (infants to older adults)
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
Chinese, English
Standards
| Standard | Name | ID | Source |
|---|---|---|---|
| Logical Observation Identifiers Names and Codes (LOINC) | Eczema proto | 62902-2 | LOINC |
| Human Phenotype Ontology | Eczema | HP:0000964 | HPO |
| caDSR Form | PhenX PX170301 - Eczema | 6186398 | caDSR Form |
Derived Variables
None
Process and Review
Not applicable.
Protocol Name from Source
The Eczema Area and Severity Index (EASI)
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 Name | Variable ID | Variable Description | dbGaP Mapping | |
|---|---|---|---|---|
| PX170301_Head_And_Neck_Area_Affected | ||||
| PX170301050000 | Head and neck percentage area affected by eczema | N/A | ||
| PX170301_Head_And_Neck_Lichenification_Score | ||||
| PX170301040000 | Head and neck lichenification score | N/A | ||
| PX170301_Head_And_Neck_Redness_Score | ||||
| PX170301010000 | Head and neck redness score | N/A | ||
| PX170301_Head_And_Neck_Scratching_Score | ||||
| PX170301030000 | Head and neck scratching score | N/A | ||
| PX170301_Head_And_Neck_Thickness_Score | ||||
| PX170301020000 | Head and neck thickness score | N/A | ||
| PX170301_Lower_Limbs_Area_Affected | ||||
| PX170301200000 | Lower limbs percentage area affected by eczema | N/A | ||
| PX170301_Lower_Limbs_Lichenification_Score | ||||
| PX170301190000 | Lower limbs lichenification score | N/A | ||
| PX170301_Lower_Limbs_Redness_Score | ||||
| PX170301160000 | Lower limbs redness score | N/A | ||
| PX170301_Lower_Limbs_Scratching_Score | ||||
| PX170301180000 | Lower limbs scratching score | N/A | ||
| PX170301_Lower_Limbs_Thickness_Score | ||||
| PX170301170000 | Lower limbs thickness score | N/A | ||
| PX170301_Trunk_Area_Affected | ||||
| PX170301150000 | Trunk percentage area affected by eczema | N/A | ||
| PX170301_Trunk_Lichenification_Score | ||||
| PX170301140000 | Trunk lichenification score | N/A | ||
| PX170301_Trunk_Redness_Score | ||||
| PX170301110000 | Trunk redness score | N/A | ||
| PX170301_Trunk_Scratching_Score | ||||
| PX170301130000 | Trunk scratching score | N/A | ||
| PX170301_Trunk_Thickness_Score | ||||
| PX170301120000 | Trunk thickness score | N/A | ||
| PX170301_Upper_Limbs_Area_Affected | ||||
| PX170301100000 | Upper limbs percentage area affected by eczema | N/A | ||
| PX170301_Upper_Limbs_Lichenification_Score | ||||
| PX170301090000 | Upper limbs lichenification score | N/A | ||
| PX170301_Upper_Limbs_Redness_Score | ||||
| PX170301060000 | Upper limbs redness score | N/A | ||
| PX170301_Upper_Limbs_Scratching_Score | ||||
| PX170301080000 | Upper limbs scratching score | N/A | ||
| PX170301_Upper_Limbs_Thickness_Score | ||||
| PX170301070000 | Upper limbs thickness score | N/A | ||
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, skin
Measure Protocols
| Protocol ID | Protocol Name |
|---|---|
| 170301 | Eczema |
Publications
There are no publications listed for this protocol.