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 respondents 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 respondents eczema. Full and half scores are allowed. The EASI© contains detailed scoring instructions.

Specific 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 Score 0
Score 0
Score 1
Score 1
Score 2
Score 2
Score 3
Score 3
Thickness Score 0
Score 0
Score 1
Score 1
Score 2
Score 2
Score 3
Score 3
Scratching Score 0
Score 0
Score 1
Score 1
Score 2
Score 2
Score 3
Score 3
Lichenification Score 0
Score 0
Score 1
Score 1
Score 2
Score 2
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
Major equipment No
Specialized training No
Specialized requirements for biospecimen collection No
Average time of greater than 15 minutes in an unaffected individual No
Mode of Administration

Physical Examination


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


Lifespan (infants to older adults)

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.


Chinese, English

Logical Observation Identifiers Names and Codes (LOINC) Eczema proto 62902-2 LOINC
Human Phenotype Ontology Eczema HP:0000964 HPO
caDSR Form PhenX PX170301 - Eczema 6186398 caDSR Form
Derived Variables


Process and Review

Not applicable.

Protocol Name from Source

The Eczema Area and Severity Index (EASI)


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 Name Variable IDVariable DescriptiondbGaP Mapping
PX170301050000 Head and neck percentage area affected by eczema N/A
PX170301040000 Head and neck lichenification score N/A
PX170301010000 Head and neck redness score N/A
PX170301030000 Head and neck scratching score N/A
PX170301020000 Head and neck thickness score N/A
PX170301200000 Lower limbs percentage area affected by eczema N/A
PX170301190000 Lower limbs lichenification score N/A
PX170301160000 Lower limbs redness score N/A
PX170301180000 Lower limbs scratching score N/A
PX170301170000 Lower limbs thickness score N/A
PX170301150000 Trunk percentage area affected by eczema N/A
PX170301140000 Trunk lichenification score N/A
PX170301110000 Trunk redness score N/A
PX170301130000 Trunk scratching score N/A
PX170301120000 Trunk thickness score N/A
PX170301100000 Upper limbs percentage area affected by eczema N/A
PX170301090000 Upper limbs lichenification score N/A
PX170301060000 Upper limbs redness score N/A
PX170301080000 Upper limbs scratching score N/A
PX170301070000 Upper limbs thickness score N/A
Measure Name


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.


eczema, itchy skin, skin inflammation, dermatitis, redness, Eczema Area and Severity Index, EASI, skin

Measure Protocols
Protocol ID Protocol Name
170301 Eczema

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