Limmer et al reported the Keloid Area and Severity Index (KASI). This reports both activity and damage scores. The authors are from University of Texas Southwestern Medical Center, Weill Cornell Medicine and Limmer Dermatology (San Antonio).
Patient selection: keloid (a patient with moderate or severe keloid disease would seem to be the preferred patient rather than someone with one or two keloids).
Damage is based on elevation and percent of BSA covered (within the body area)
Elevation is graded:
(0) < 0.5 cm
(1) 0.5 to 0.99 cm
(2) 1.0 to 2.99 cm
(3) >= 3 cm
Body surface area is graded (subscore D):
(1) < 10%
(2) 10 to 24.99%
(3) 25 to 49.99 %
(4) 50 to 74.99 cm
(5) >= 75%
Sites examined:
(1) ears
(2) head and neck
(3) trunk
(4) arm and hand
(5) leg and foot
subscore C1 = SUM(points for the least severe elevation in each area)
subscore C2 = SUM(points for the most severe elevation in each area
damage score =
= (subscore for C1) + (subscore for C2) + (0.1 * (ear BSA grade)) + (0.7 * (head and neck BSA grade)) + (3.2 * (trunk BSA grade)) + (2 * (arm and hand BSA grade)) + (4 * (leg and foot BSA grade))
Interpretation:
• minimum C1 + C2: 0
• maximum C1: C2: 30
• minimum D score: 0
• maximum D score: 50.
• maximum total damage score: 80
• The higher the damage score the greater the damage.
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