Protocol - Eczema
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.
The Eczema Area and Severity Index©
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
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)
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
- 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
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.
The interviewer will need a copy of the Eczema Area and Severity Index (EASI)©, which includes the scoring instructions.
|Specialized requirements for biospecimen collection||No|
|Average time of greater than 15 minutes in an unaffected individual||No|
Mode of Administration
Infant, Toddler, Child, Adolescent, Adult, Senior, Pregnancy
Lifespan (infants to older adults)
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.
|caDSR Common Data Elements (CDE)||Skin Eczema Assessment Score||3158234||CDE Browser|
|Logical Observation Identifiers Names and Codes (LOINC)||Eczema proto||62902-2||LOINC|
|Human Phenotype Ontology||Eczema||HP:0000964||HPO|
Process and Review
Protocol Name from Source
The Eczema Area and Severity Index (EASI)
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.
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.
|Variable Name||Variable ID||Variable Description||dbGaP Mapping|
|PX170301050000||Head and neck percentage area affected by eczema||N/A|
|PX170301040000||Head and neck lichenification score||N/A|
|PX170301010000||Head and neck redness score||N/A|
|PX170301030000||Head and neck scratching score||N/A|
|PX170301020000||Head and neck thickness score||N/A|
|PX170301200000||Lower limbs percentage area affected by eczema||N/A|
|PX170301190000||Lower limbs lichenification score||N/A|
|PX170301160000||Lower limbs redness score||N/A|
|PX170301180000||Lower limbs scratching score||N/A|
|PX170301170000||Lower limbs thickness score||N/A|
|PX170301150000||Trunk percentage area affected by eczema||N/A|
|PX170301140000||Trunk lichenification score||N/A|
|PX170301110000||Trunk redness score||N/A|
|PX170301130000||Trunk scratching score||N/A|
|PX170301120000||Trunk thickness score||N/A|
|PX170301100000||Upper limbs percentage area affected by eczema||N/A|
|PX170301090000||Upper limbs lichenification score||N/A|
|PX170301060000||Upper limbs redness score||N/A|
|PX170301080000||Upper limbs scratching score||Variable Mapping|
|PX170301070000||Upper limbs thickness score||N/A|
November 12, 2010
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.
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.
eczema, itchy skin, skin inflammation, dermatitis, redness, Eczema Area and Severity Index, EASI, skin