Evaluation of patient's subjective severity using various scoring system in Korean children with atopic dermatitis.

Background: Although several scoring systems are available to measure the severity of atopic dermatitis (AD), they all have limitations with regard to the subjective expression of severity by patients.

Objective: This study was designed to evaluate the correlation of patients subjective symptom score with various scoring systems.

Methods: Fifty children with AD were recruited from the pediatric allergy and respiratory center at Soonchunhyang University hospital from June 1 to July 31, 2007. We measured their SCORAD score, EASI score, SASSAD score, parental visual analog scale (PTVAS, 0-10 point), and investigator visual analog scale (INVAS, 0-10 point). Each scoring system was analyzed and the results compared.

Results: The objective scoring systems including the SCORAD, EASI, and SASSAD showed a statistically significant correlation. (SCORAD vs. EASI; r = 0.84, SCORAD vs SASSAD; r = 0.92, and EASI vs. SASSAD; r = 0.86) The INVAS showed a more significant correlation than the PTVAS with the objective scores (SCORAD, EASI, and SASSAD). (r = 0.60, 0.52, 0.52 vs. 0.37, 0.23, 0.33)

Conclusions: Our results demonstrated that all scoring systems did not reflect the subjective severity experienced by the patient. Therefore, a new severity scoring system including the subjective symptoms is needed. In addition, patient's subjective symptoms are a point to be considered by physician.