Assessment of atopic eczema: clinical scoring and noninvasive measurements.
BACKGROUND
Clinical scoring systems are widely used in clinical trials of atopic eczema (AE), while noninvasive methods are more often used for research purposes. Positive correlations between the two types of methods may be used in support of the validity of both in a clinical context. Few studies are available of the association between clinical scores and instrumental assessment of disease severity obtained with noninvasive instruments.


OBJECTIVE
To compare clinical scores in AE with biometric data in AE.


METHODS
Transepidermal water loss, stratum corneum hydration, erythema, scaling and subepidermal oedema were measured. 'Scoring of Atopic Dermatitis (SCORAD)', 'Eczema Area and Severity Index (EASI)' and 'Atopic Dermatitis Severity Index (ADSI)' were used for clinical scores. Two assessments at 6-month intervals at the antecubital fossa, dorsal forearm and popliteal fossa in 101 patients with AE and 30 controls were carried out.


RESULTS
Significant correlations were found within the clinical scores (P < 0.0001 and r = 0.85-0.91) and between instruments and clinical scores (P < 0.0001 and r = 0.61-0.79).


CONCLUSIONS
The various instruments and clinical scores showed internal agreement and noninvasive methods correlated significantly with the three different clinical scorings systems. This observation suggests that both methods provide data of clinical (scores) and biological (instrumental measures) relevance, and may be useful in future studies of AE. It is speculated that combined measures including scores and selected instruments may be particularly useful.
Holm
E A
EA
Division of Dermatology, Department of Medicine, Roskilde Hospital, University of Copenhagen, Koegevej 7-13, D-4000 Roskilde, Denmark. rselho@ra.dk
Wulf
H C
HC
Thomassen
L
L
Jemec
G B E
GB
D000293:Adolescent; D000328:Adult; D001834:Body Water / Q000378:metabolism; D002648:Child; D002675:Child, Preschool; D003876:Dermatitis, Atopic / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology; D004487:Edema / Q000209:etiology; D004817:Epidermis / Q000378:metabolism; D004890:Erythema / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012720:Severity of Illness Index; D014870:Water Loss, Insensible