SCORAD: ATOPIC DERMATITIS SEVERITY ASSESSMENT:

PROCEDURE:

VIVA QUESTIONS:

SCORAD SCORE

SCENARIO:

A 10 year old boy with a history of Atopic eczema is brought to your OPD with exacerbation in the legs. Calculate SCORAD for this patient.

📍What does the SCORAD score represent?

🔸SCORAD represents the state of eczema over the past 3 days.

📍Difference between rule of nine calculation of BSA according to age?

🔸 Less than 2 yrs old : 

▪️head is total 17 % 

▪️Back of each leg is 6%

▪️Rest all is same as for older children/adults.

📍Max and minimum SCORAD?

🔸Max – 103

🔸Min – zero

📍 Interpretation of SCORAD?

🔸< 25 – mild

🔸25 – 50 – moderate

🔸> 50 – severe

📍What is PO-SCORAD?

🔸 It is Patient Oriented SCORAD. The patients are taught to calculate the SCORAD themselves. It allows patients to self assess the severity of their eczema. Self assessment helps you to better monitor and better treat your eczema.

📍Important point for SCORAD:

🔸When scoring intensity features, look for the ones most representative of the patients eczema (not the best or worst features)

📍What is Hanifin and Rajka diagnostic criteria of Atopic eczema?

🔸**An itchy skin condition (or parental report of scratching or rubbing in a child)

Plus three or more of the following:

1. Onset below age of 2 years (not used if child is under 4 years)

2. History of skin crease involvement (including cheeks in children under 10 years)

3. History of a generally dry skin 

4. Personal history of other atopic disease (or history of any atopic disease in a first‐degree relative in children under 4 years)

5. Visible flexural dermatitis (or dermatitis of cheeks/forehead and outer limbs in children under 4 years)

📍What is hygiene hypothesis of atopy?

🔸The hygiene hypothesis of atopic disease suggests that environmental changes in the industrialized world have lead to reduced microbial contact at an early age and thus resulted in the growing epidemic of atopic eczema, allergic rhinoconjunctivitis, and asthma

📍Other scoring systems for atopic eczema?

🔸EASI (eczema area and severity index)

🔸SASSAD (Six area, six sign atopic dermatitis)

🔸POEM (Patient Oriented eczema measure)

Subjective symptoms are asked with regards to the past 3 days