Williams et al used a clinical scale to grade the severity of the allergic contract dermatitis caused by uroshiol following exposure to poison ivy or poison oak. This can determine the severity of the exposure and can be used to evaluate the response to therapeutic interventions. The authors are from the Milton S. Hershey Medical Center in Hershey, Pennsylvania.
The description given about the scale:
(1) It ranged from 0 to 7
(2) Grade 0 indicated no reaction.
(3) Grade 7+ involved erythema, edema, vesiculation, and ulceration.
Unfortunately the description of the intermediate grades was not provided.
Features of acute allergic contact dermatitis (from Ale and Maibach):
(1) erythema
(2) edema
(3) vesicles, which may be intense
(4) necrosis or ulceration is rare
Based on these factors the following tentative grading scale is proposed (pending modifications).
Erythema
Edema
Vesiculation
Ulceration
Grade
absent
absent
absent
absent
0
mild
absent
absent
absent
1+
moderate
minimal
absent
absent
2+
moderate to severe
mild
few
absent
3+
severe
moderate
some
absent
4+
severe
moderate to severe
diffuse
absent
5+
severe
severe with weeping
confluent
absent
6+
NA
NA
NA
present
7+
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