The Atopic Dermatitis Area and Severity Index (ADASI) score is a simple method for measuring the extent of involvement in patients with atopic dermatitis. Three different colors are used to document the extent and severity of skin involvement, then a counting grid is used to measure the number of points falling on the different areas. It can be used to monitor the patient over time and to evaluate response to therapeutic interventions.
Procedure:
(1) A standard diagram showing the front and back human form is colored by the examiner or the patient according to the severity of skin involvement.
(2) Unaffected areas are left uncolored.
(3) Areas showing slight erythema with or without scaling are colored green.
(4) Areas with infiltrating erythema and scaling are colored blue.
(5) Areas showing severe inflammation with oozing, scaling and/or lichenification are colored red.
Scoring:
(1) A clear plastic grid with counting squares is placed over the front and back diagrams. The grid size should allow for at least 100 points to fall on both the front and back diagrams combined.
(2) The number of points falling on green colored areas are counted.
(3) The number of points falling on blue colored areas are counted.
(4) The number of points falling on red colored areas are counted.
(5) The number of points falling on unaffected areas (noncolored) are counted.
total points counted =
= SUM(all points falling on front and back diagrams)
where
• severity of itching score = analog scale from 0 to 5, with 0 indicating none and 5 indicating very severe
ADASI score =
= ((points on green colored areas) + (2 * (points on blue colored areas)) + (3 * (points on red colored areas))) / (total points) * ((severity of itching score) + 1)
Interpretation:
• minimum score: 0 (indicating free of atopic dermatitis signs and symptoms)
• maximum value: 18 (indicating very severe atopic dermatitis)
