A practical guide to Assessment tools used in Atopic Eczema Sheila Ryan, RANP Dermatology
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
POEM Patient Oriented Eczema Measure
POEM Patient rather than physician view Copyright University of Nottingham Recommended by Harmonizing Outcome Measure for Eczema (HOME)
POEM Variations Child Adult Both
POEM Scoring 7 point questionnaire. Ask to rate questions on symptoms occurrence No days = 0 1-2 days = 1 3-4 days = 2 5-6 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.
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
POEM Interpretation Score Interpretation 0-2 Clear or almost clear 3-7 Mild Eczema 8-16 Moderate Eczema 17-24 Severe Eczema 25-28 Very Severe Eczema
Investigators Global Assessment Score Category 0 Clear 1 Almost Clear 5-point scale 2 Mild 3 Moderate 4 Severe
EASI Eczema Area Severity Index Available on Harmonizing Outcome Measure for Eczema (HOME) www.homeforeczema.org Hard copy and app
Area Score- EASI
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
0 A b s e n t Erythema Score EASI 2 Moderate 3 1 Mild S e v e r e
Eczema on dark skin More difficult to assess Erythema especially Go 1 category above (E Simpson HOME)
Papulation/ Induration EASI 0 Absent 1 Mild 2 Moderate 3 Severe
Excoriation - EASI 0 Absent 1 Mild 2 Moderate 3 Severe
Lichenification - EASI 0 Absent 2 Moderate Lichenification Vs Palpability Lichenified Chronic & Firm Palpability Acute & Spongy (E Simpson HOME) 1 Mild 3 Severe
EASI < 8
EASI > 8
EASI Interpretation Score Interpretation 0 Clear 0.1-1.0 Almost Clear 1.1 7.0 Mild 7.1 21.0 Moderate 21.1 50.0 Severe 50.1 72.0 Very Severe
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
SCORAD
A-Extent SCORAD
B-Intensity SCORAD From representative (average) area of eczema 0-3 6 categories Maximum score B - 18
Erythema Score SCORAD 0 Absent 1 Mild 2 Moderate 3 S e v e r e
Papulation/ Induration SCORAD 0 Absent 1 Mild 2 Moderate 3 Severe
Oozing / Crusting SCORAD 0 Absent 1 Mild 2 Moderate 3 Severe
Excoriation - SCORAD 0 Absent 1 Mild 2 Moderate 3 Severe
Lichenification - SCORAD 0 Absent ) 1 Mild 2 Moderate 3 Severe
Dryness SCORAD 0 Absent 1 Mild 2 Moderate
C- Subjective Symptoms SCORAD Scored by patient 2 Categories Itch and Sleeplessness Visual analogue scale 0 10 Maximum Score C - 20
Total Score - SCORAD A Area/5 + 7 x B Intensity /2 + C Subjective Symptoms
Thank Ewe