Proposal for an easy and rapid way of measuring atopic dermatitis severity

Linked Article: Paller et al. Br J Dermatol 2022; 186:496–507. Atopic dermatitis (or eczema) causes dry and itchy skin. It is found in up to 7% of adults and 22% of children. This study looked at a large number of patients (adults, adolescents and children) with atopic dermatitis from all over the world. The data used in the study was collected during nine large clinical studies, looking at the effectiveness and safety of the drug dupilumab in treating atopic dermatitis. Dupilumab is a medication that is approved to treat moderate-to-severe atopic dermatitis in several countries. Usually, in clinical studies doctors need to use complex and time-consuming measurements to assess atopic dermatitis severity. The two main scoring systems used are the Eczema Area and Severity Index (EASI) and the SCORing Atopic Dermatitis (SCORAD). However, each of these scoring systems take 6–10 minutes to complete. In this study, we used a more straightforward system, the product of two quick and easy measurements. The Investigator's Global Assessment (IGA) is the ‘first visual impression’ the physician has about how severe the skin changes are. The body surface area (BSA) is also a quick measure, but of what percentage of the total skin has atopic dermatitis. The measure we studied is just a multiplication of these two measures and we call it ‘IGAxBSA’. Accuracy is the term used to say how well an instrument measures something. We compared data collected during up to 1 year in more than 3000 patients and found that IGAxBSA has similar accuracy to the EASI and SCORAD scoring systems. We also found that the new measurement tool accurately measured how patients responded to treatment with time. As atopic dermatitis can appear differently in patients with different skin colour, we also looked at whether IGAxBSA worked as well in people with different ethnicity and found that it worked just as well in all patients.