Protocol - Eczema

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The Eczema Area and Severity Index© (EASI) is a tool to determine the level of severity and extent of atopic eczema. The EASI© is completed by a physician or trained assistant observing four regions of the respondent's body for the presence of four features of eczema. Each feature is given a score and the scores are used to determine the severity of the respondent's eczema. Full and half scores are allowed. The EASI© contains detailed scoring instructions.


The Eczema Area and Severity Index©


A representative area of eczema is selected for each body region. The intensity of redness (erythema), thickness (induration, papulation, oedema), scratching (excoriation) and lichenification (lined skin) of the eczema is assessed as none (0), mild (1), moderate (2), and severe (3). Half scores are allowed.

Eczema: severity scoring






Redness [img[eczema_easi_image001.jpg|Score 0]]
Score 0
[img[eczema_easi_image002.jpg|Score 1]]
Score 1
[img[eczema_easi_image003.jpg|Score 2]]
Score 2
[img[eczema_easi_image004.jpg|Score 3]]
Score 3
Thickness [img[eczema_easi_image005.jpg|Score 0]]
Score 0
[img[eczema_easi_image006.jpg|Score 1]]
Score 1
[img[eczema_easi_image007.jpg|Score 2]]
Score 2
[img[eczema_easi_image008.jpg|Score 3]]
Score 3
Scratching [img[eczema_easi_image009.jpg|Score 0]]
Score 0
[img[eczema_easi_image010.jpg|Score 1]]
Score 1
[img[eczema_easi_image011.jpg|Score 2]]
Score 2
[img[eczema_easi_image012.jpg|Score 3]]
Score 3
Lichenification [img[eczema_easi_image013.jpg|Score 0]]
Score 0
[img[eczema_easi_image014.jpg|Score 1]]
Score 1
[img[eczema_easi_image015.jpg|Score 2]]
Score 2
[img[eczema_easi_image016.jpg|Score 3]]
Score 3

Calculation for intensity

The four intensity scores are added up for each of the four body regions to give subtotals A1, A2, A3, A4.

Each subtotal is multiplied by the body surface area represented by that region.

  • A1 x 0.1 gives B1 (in children 0–7 years, A1 x 0.2 gives B1)
  • A2 x 0.2 gives B2
  • A3 x 0.3 gives B3
  • A4 x 0.5 gives B4 (in children 0–7 years, A1 x 0.3 gives B1)


The percentage area affected by eczema is evaluated in the four regions of the body. In each region, the area is expressed as nil (0), 1%–9% (1), 10%–29% (2), 30%–49% (3), 50%–69% (4), 70%–89% (5), or 90%–100% (6).

  • Head and neck
  • Upper limbs
  • Trunk
  • Lower limbs

Calculations for area

Each of the body area scores is multiplied by the area affected.

  • B1 x (0 to 6) = C1
  • B2 x (0 to 6) = C2
  • B3 x (0 to 6) = C3
  • B4 x (0 to 6) = C4

Total score

The EASI© score is C1 + C2 + C3 + C4.

The Eczema Area and Severity Index ©2010 the New Zealand Dermatological Society Incorporated (NZDSI). All rights reserved.

Personnel and Training Required

If the examiner is not a physician, he or she must be trained and found to be competent (i.e., tested by an expert) in conducting physical examinations for atopic eczema.

Equipment Needs

The interviewer will need a copy of the Eczema Area and Severity Index (EASI)©, which includes the scoring instructions.


Requirement CategoryRequired
Average time of greater than 15 minutes in an unaffected individualNo
Major equipmentNo
Specialized requirements for biospecimen collectionNo
Specialized trainingNo

Mode of Administration

Health Professional

Life Stage:

Infant, Toddler, Child, Adolescent, Adult, Senior, All Ages, Pregnancy

Specific Instructions:


Research Domain Information

Release Date:

November 12, 2010


This measure is a physical examination of four areas of the body to determine whether the respondent has atopic eczema and to assess the severity of the disease.


This measure can be used to assess the presence and severity of eczema, a type of inflammation or dermatitis of the skin, which affects various populations at any age. It can be associated with asthma, allergies, immunodeficiencies, and other autoimmune diseases such as alopecia areata.

Selection Rationale

The Eczema Area and Severity Index (EASI)© was selected because it is a widely used, minimally invasive examination tool that can be completed by a trained research assistant in a few minutes. Additionally, the Eczema Area and Severity Index© has a straightforward scoring method which allows for half scores.




Common Data Elements (CDE)Skin Eczema Assessment Score3158234CDE Browser
Logical Observation Identifiers Names and Codes (LOINC)Eczema proto62902-2LOINC

Process and Review

The Expert Review Panel has not reviewed this measure yet.


Hanifin, J. M., Thurston, M., Omoto, M., Cherill, R., Tofte, S. J., & Graeber, M. (2001). The Eczema Area and Severity Index (EASI): Assessment of reliability in atopic dermatitis. EASI Evaluator Group. Experimental Dermatology, 10(1), 11–18.

General References

Schmitt, J., Langan, S., Williams, H. C., & the European Dermato-Epidemiology Network. (2007). What are the best outcome measurements for atopic eczema? A systematic review. Journal of Allergy and Clinical Immunology, 120(6), 1389–1398. Epub 2007 Oct 1. Review.

Beck, L. A., Boguniewicz, M., Hata, T., Schneider, L. C., Hanifin, J., Gallo, R., Paller, A. S., Lieff S., Reese, J., Zaccaro, D., Milgrom, H., Barnes, K. C., & Leung, D. Y. (2009). Phenotype of atopic dermatitis subjects with a history of eczema herpeticum. Journal of Allergy and Clinical Immunology, 124(2), 260–269, 269.e1-7.

Protocol ID:



Export Variables
Variable NameVariable IDVariable DescriptionVersiondbGaP Mapping
PX170301_Head_And_Neck_Redness_ScorePX170301010000Head and neck redness score4N/A
PX170301_Head_And_Neck_Thickness_ScorePX170301020000Head and neck thickness score4N/A
PX170301_Head_And_Neck_Scratching_ScorePX170301030000Head and neck scratching score4N/A
PX170301_Head_And_Neck_Lichenification_ScorePX170301040000Head and neck lichenification score4N/A
PX170301_Head_And_Neck_Area_AffectedPX170301050000Head and neck percentage area affected by eczema4N/A
PX170301_Upper_Limbs_Redness_ScorePX170301060000Upper limbs redness score4N/A
PX170301_Upper_Limbs_Thickness_ScorePX170301070000Upper limbs thickness score4N/A
PX170301_Upper_Limbs_Scratching_ScorePX170301080000Upper limbs scratching score4N/A
PX170301_Upper_Limbs_Lichenification_ScorePX170301090000Upper limbs lichenification score4N/A
PX170301_Upper_Limbs_Area_AffectedPX170301100000Upper limbs percentage area affected by eczema4N/A
PX170301_Trunk_Redness_ScorePX170301110000Trunk redness score4N/A
PX170301_Trunk_Thickness_ScorePX170301120000Trunk thickness score4N/A
PX170301_Trunk_Scratching_ScorePX170301130000Trunk scratching score4N/A
PX170301_Trunk_Lichenification_ScorePX170301140000Trunk lichenification score4N/A
PX170301_Trunk_Area_AffectedPX170301150000Trunk percentage area affected by eczema4N/A
PX170301_Lower_Limbs_Redness_ScorePX170301160000Lower limbs redness score4N/A
PX170301_Lower_Limbs_Thickness_ScorePX170301170000Lower limbs thickness score4N/A
PX170301_Lower_Limbs_Scratching_ScorePX170301180000Lower limbs scratching score4N/A
PX170301_Lower_Limbs_Lichenification_ScorePX170301190000Lower limbs lichenification score4N/A
PX170301_Lower_Limbs_Area_AffectedPX170301200000Lower limbs percentage area affected by eczema4N/A