Dreno et al developed the ECCA (Echelle D'Evaluation Clinique des Cicatrices D'Acne) grading scale to assess the severity of acne-related scarring. It can be used over time to monitor the response of the acne scars to treatment. The authors are from CHU Nantes and other dermatology clinics in France.
Parameters:
(1) V-shaped atrophic ulcers (punctiform and < 2 mm in diameter)
(2) U-shaped atrophic ulcers (2 to 4 mm in diameter with sheer edges)
(3) M-shaped atrophic ulcers (> 4 mm with irregular surface)
(4) superficial elastolysis
(5) hypertrophic inflammatory scars less than 2 years in duration
(6) keloid or hypertrophic inflammatory scars more than 2 years in duration
|
Parameter |
Finding |
Points |
|
V-shaped atrophic scars |
none |
0 |
|
|
few |
15 |
|
|
limited number |
30 |
|
|
many |
45 |
|
U-shaped atrophic scars |
none |
0 |
|
|
few |
20 |
|
|
limited number |
40 |
|
|
many |
60 |
|
M-shaped atrophic scars |
none |
0 |
|
|
few |
25 |
|
|
limited number |
50 |
|
|
many |
75 |
|
superficial elastolysis |
none |
0 |
|
|
mild |
30 |
|
|
moderate |
60 |
|
|
intense |
90 |
|
hypertrophic scar for < 2 years |
none |
0 |
|
|
few |
40 |
|
|
limited number |
80 |
|
|
many |
120 |
|
keloid or hypertrophic scar > 2 years |
none |
0 |
|
|
few |
50 |
|
|
limited number |
100 |
|
|
many |
150 |
where:
• The point assignment is based on a value for number of lesions times a weighting factor for each scar type.
• The number of lesions are scored 0, 1, 2, or 3.
• The weighting factor for each scar type range from 15 for V-shaped atrophic scar to 50 for a keloid scar > 2 years old
subscore 1 =
= SUM(points for the first 4 items)
subscore 2 =
= SUM(points for the last 2 items)
total score =
= (points for subscore 1) + (points for subscore 2)
Interpretation:
• minimum score: 0
• maximum score: 540
• The higher the score the more severe the acne scarring.
Specialty: Dermatology, Infectious Diseases, Pedatrics, Otolaryngology
