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Author: Hon A/Prof Amanda Oakley, Dermatologist, Hamilton, New Zealand. Updated January 2015.
An EASI score is a tool used to measure the extent (area) and severity of atopic eczema (Eczema Area and Severity Index). It takes a few minutes and experience to calculate it accurately. Then it's easy!
EASI score does not include a grade for dryness or scaling. Include only inflamed areas.
There are four body regions:
Area score is recorded for each of the four regions of the body. The area score is the percentage of skin affected by eczema for each body region.
|Area score||Percentage of skin affected by eczema in each region|
|0||No active eczema in this region|
|6||90–100%: the entire region is affected by eczema|
Severity score is recorded for each of the four regions of the body. The severity score is the sum of the intensity scores for four signs. The four signs are:
The average intensity of each sign in each body region is assessed as: none (0), mild (1), moderate (2) and severe (3).
|Score||Intensity of redness, thickness/swelling, scratching, lichenification|
|1||Mild (just perceptible)|
Half scores are allowed. It may be difficult to assess redness in dark skin. If in doubt, increase the average redness score by one level. The 16 images below have been chosen as typical examples of different intensities of each sign.
Intensity of redness
For each region, record the intensity for each of four signs and calculate the severity score.
For each region, multiple the severity score by the area score and by a multiplier. The multiplier is different for each body site.
Add up the total scores for each region to determine the final EASI score. The minimum EASI score is 0 and the maximum EASI score is 72.
|Body region||Redness||Thickness||Scratching||Lichenification||Severity score||Area score||Multiplier||Region score|
|Head/neck||_______||+_______||+_______||+_______||=_______||X_______||X 0.1 (If ≤7 yrs, X 0.2)||=_______|
|Upper limbs||_______||+_______||+_______||+_______||=_______||X_______||X 0.2||=_______|
|Lower limbs||_______||+_______||+_______||+_______||=_______||X_______||X 0.4 (If ≤7 yrs, X 0.3)||=_______|
|The final EASI score: add up the 4 region scores||=_______ (0-72)|
A 3-year-old child has an acute flare-up of atopic eczema. The flare-up affects limb flexures, and the child's trunk is also rather pink and dry.
The calculations for each region are severity score x area score x multiplier.
EASI = 2.4 + 1.0 + 6.0 = 9.4.
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