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The Atopic Dermatitis Severity Index (ADSI)

Purpose: To use the Atopic Dermatitis Severity Index (ADSI) to evaluate a defined skin area for severity of signs and symptoms associated with atopic dermatitis.

Description

The Atopic Dermatitis Severity Index (ADSI) was a scoring system developed by Van Leent et al to measure response to topical treatment in patients with atopic dermatitis. It was based on clinical features described by Hanifin (see "Simplified Scoring").


Area selection:

• Areas were selected for studying effectiveness of topical treatment.

• Patients with symmetrical involvement of both arms were used, with the two sides having scores within 1 point of each other.

• The effect of the medication vs placebo could then be compared.

 

Symptoms used for score:

(1) pruritis

(2) erythema

(3) exudation

(4) excoriation

(5) lichenification

 

Severity of Symptom

Points

none, absent

0

mild

1

moderate

2

severe

3

 

ADSI score =

= SUM(points for all 5 symptoms)

 

Interpretation:

• minimum score: 0

• maximum score: 15

• The higher the score, the more severe the atopic dermatitis.

• The ADSI score before treatment was >= 6.

• Partial clearance was an ADSI = 1 or 2; complete clearance was an ADSI = 0

 

Limitations:

• The score was used for small areas treated with a topical medication or placebo. Most other scores for atopic dermatitis take into account the total body involvement.

• Charman and Williams could find no data on criterion or construct validity, nor on reliability testing for the index.


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Specialty

Objective

ICD-10