A practical guide to Assessment tools used in Atopic Eczema. Sheila Ryan, RANP Dermatology

Transcription

1 A practical guide to Assessment tools used in Atopic Eczema Sheila Ryan, RANP Dermatology

2 Learning Outcomes Understand assessment tools used in Atopic Eczema POEM, IGA, EASI, SCORAD Be able to identify the advantages & disadvantages of each tool Be able to utilize each tool

3 POEM Patient Oriented Eczema Measure

4 POEM Patient rather than physician view Copyright University of Nottingham Recommended by Harmonizing Outcome Measure for Eczema (HOME)

5 POEM Variations Child Adult Both

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7 POEM Scoring 7 point questionnaire. Ask to rate questions on symptoms occurrence No days = days = days = days = 3 Every day = 4 Maximum Score = 28 1 Question not answered - score 0 More than 1 not answered not valid 2 answers selected in a question score the highest.

8 POEM Availability Centre for Evidence Based Dermatology University of Nottingham Paper Format for download App My Eczema Tracker Google Play/ App store Various languages English/ Chinese/ Danish/ Finnish/ French/ German/ Japanese/ Russian Spanish/ Swedish

9 POEM Interpretation Score Interpretation 0-2 Clear or almost clear 3-7 Mild Eczema 8-16 Moderate Eczema Severe Eczema Very Severe Eczema

10 Investigators Global Assessment Score Category 0 Clear 1 Almost Clear 5-point scale 2 Mild 3 Moderate 4 Severe

11 EASI Eczema Area Severity Index Available on Harmonizing Outcome Measure for Eczema (HOME) Hard copy and app

12 Area Score- EASI

13 Severity Assessment 4 key signs in each body region 1. Erythema (redness) 2. Oedema / papulation (swelling and bumpiness) 3. Excoriation (scratch marks) 4. Lichenification ( leatheriness ) Score the degree of severity of each sign for each body region separately 0 None 1 Mild 2 Moderate 3 Severe Take an average of the severity across the involved area Half points may be used e.g. 2.5 except when averaging 2 limbs 0.5 not used either 1 or 0 Palpation may be useful in assessing oedema/papulation as well as lichenification

14 0 A b s e n t Erythema Score EASI 2 Moderate 3 1 Mild S e v e r e

15 Eczema on dark skin More difficult to assess Erythema especially Go 1 category above (E Simpson HOME)

16 Papulation/ Induration EASI 0 Absent 1 Mild 2 Moderate 3 Severe

17 Excoriation - EASI 0 Absent 1 Mild 2 Moderate 3 Severe

18 Lichenification - EASI 0 Absent 2 Moderate Lichenification Vs Palpability Lichenified Chronic & Firm Palpability Acute & Spongy (E Simpson HOME) 1 Mild 3 Severe

19 EASI < 8

20 EASI > 8

21 EASI Interpretation Score Interpretation 0 Clear Almost Clear Mild Moderate Severe Very Severe

22 SCORAD SCORing Atopic Dermatitis SCORAD Validated eczema severity tool Developed by European Task Force on Atopic Dermatitis 1990 Available hard copy and app Information- SCORAD Foundation for Atopic Dermatitis

23 SCORAD

24 A-Extent SCORAD

25 B-Intensity SCORAD From representative (average) area of eczema categories Maximum score B - 18

26 Erythema Score SCORAD 0 Absent 1 Mild 2 Moderate 3 S e v e r e

27 Papulation/ Induration SCORAD 0 Absent 1 Mild 2 Moderate 3 Severe

28 Oozing / Crusting SCORAD 0 Absent 1 Mild 2 Moderate 3 Severe

29 Excoriation - SCORAD 0 Absent 1 Mild 2 Moderate 3 Severe

30 Lichenification - SCORAD 0 Absent ) 1 Mild 2 Moderate 3 Severe

31 Dryness SCORAD 0 Absent 1 Mild 2 Moderate

32 C- Subjective Symptoms SCORAD Scored by patient 2 Categories Itch and Sleeplessness Visual analogue scale 0 10 Maximum Score C - 20

33 Total Score - SCORAD A Area/5 + 7 x B Intensity /2 + C Subjective Symptoms

34 Thank Ewe