George et al used a clinical score to evaluate patients with atopic dermatitis based on the score of Costa et al (see above). It is weighted 30% for extent of disease and 70% for morphology of the skin lesions and pruritus (following recommendations from the Third International Symposium on Atopic Dermatitis). The authors are from Ninewells Hospital in Dundee, U.K.
Parameters:
(1) extent of disease
(2) morphology
(3) itch/pruritus
Sites assessed for extent of disease:
(1) feet
(2) legs
(3) popliteal fossa
(4) hands
(5) arms
(6) buttocks
(7) back of neck and trunk
(8) chest and abdomen
(9) face and front of neck
(10) back of head
Involvement |
Points |
none |
0 |
1 - 24% |
1 |
25 - 50% |
2 |
51 - 75% |
3 |
76 - 100% |
4 |
Morphologic changes:
(1) erythema and/or edema
(2) vesicles, crust and/or pustules
(3) excoriations
(4) dryness and/or scaling
(5) lichenification
(6) cracking of the skin
Severity of Morphology |
Grades |
none |
0 |
mild |
4 |
moderate |
8 |
severe |
12 |
Itch and pruritus is graded on visual analogue scale (VAS) measuring 6.6 cm in length and scored from 0 to 10.
points for itch =
= (score along itch scale) * 1.5
total score =
= SUM(points for all 3 parameters)
Interpretation:
• minimum score: 0
• maximum score: 40 + 72 + 15 = 127
• The higher the score, the more severe the disease.
In addition, the patient gave a global score for disease severity similar to the itch and pruritus VAS.
Specialty: Dermatology