Eczema Area and Severity Index

The Eczema Area and Severity Index (EASI) is a validated tool for the measurement of severity of atopic dermatitis. It ranges from 0 (no disease) to 72 (maximal disease).[1][2] The EASI was developed in 1998 by modifying the Psoriasis Area and Severity Index (PASI), a widely accepted scoring system for psoriasis.[3]

Eczema Area and Severity Index
Purposemeasurement of severity of atopic dermatitis

EASI is one of the core outcome instruments recommended to be included in all clinical trials on atopic dermatitis by the Harmonising Outcome Measures for Eczema (HOME) group.[4]

Calculation

Similar to the PASI, the EASI divides the body into four regions. The head and neck (H) are assigned 10% of the body surface area, the upper limbs (U) 20%, the trunk (T) 30%, and lower limbs (L) 40%.[5] The area of involvement is determined visually for each region, and the percentage of skin affected is converted into an area score as follows:

  1. 0% of involved area
  2. 1-9% of involved area
  3. 10–29% of involved area
  4. 30–49% of involved area
  5. 50–69% of involved area
  6. 70–89% of involved area
  7. 90–100% of involved area

A severity score is then calculated for each region. The total severity score for a region is equal to the sum of the intensity scores for four clinical signs, erythema, edema/papulation, excoriation, and lichenification. The average intensity for each sign is assigned a score of 0 to 3, with 0 being none and 3 being severe.

The region score is then calculated by multiplying the severity score for each region by the corresponding area score and area multiplier (0.1 for head, 0.2 for upper limbs, 0.3 for trunk, and 0.4 for lower limbs).

The final EASI score is the sum of the four regional scores.

See also

References
  1. 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. doi:10.1034/j.1600-0625.2001.100102.x. PMID 11168575. S2CID 25864663.
  2. Leshem, Y. A.; Hajar, T; Hanifin, J. M.; Simpson, E. L. (2015). "What the Eczema Area and Severity Index score tells us about the severity of atopic dermatitis: An interpretability study". British Journal of Dermatology. 172 (5): 1353–7. doi:10.1111/bjd.13662. PMID 25580670. S2CID 207072864.
  3. Tofte, Susan J.; Graeber, Michael; Cherill, Robert J.; Omoto, Mitsuyoshi; Thurston, Mark; Hanifin, Jon (1 September 1998). "Eczema area and severity index (EASI): A new tool to evaluate atopic dermatitis". Journal of the European Academy of Dermatology and Venereology. 11 (Supplement 2): S197. doi:10.1016/S0926-9959(98)95291-6. ISSN 0926-9959. S2CID 72210425.
  4. Schmitt, J.; Spuls, P. I.; Thomas, K. S.; Simpson, E.; Furue, M.; Deckert, S. (2014). "The Harmonising Outcome Measures for Eczema (HOME) statement to assess clinical signs of atopic eczema in trials". The Journal of Allergy and Clinical Immunology. 134 (4): 800–807. doi:10.1016/j.jaci.2014.07.043. PMID 25282560.
  5. Hanifin, JM; Baghoomian, W; Grinich, E; Leshem, YA; Jacobson, M; Simpson, EL (2022). "The Eczema Area and Severity Index—A Practical Guide". Dermatitis. 33 (3): 187–192. doi:10.1097/DER.0000000000000895. PMC 9154300. PMID 35594457.
  • "EASI score". DermNet New Zealand. Retrieved 1 May 2015. With calculation guide and scoring pictures.
  • "HOME core outcomes for eczema". HOME initiative. Retrieved 6 Jan 2017. Information on how to use EASI, scoring sheets, and details of all core outcome instruments including EASI for all eczema / atopic dermatitis trials.
  • "Web Components fpr EASI Score". Antix Software. Retrieved 17 Jun 2019. Web Components for calculating EASI scores
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