SCORAD (SCORing Atopic Dermatitis) is a severity index for atopic dermatitis developed by the European Task Force on Atopic Dermatitis (ETFAD) in 1993. It combines extent, intensity and subjective symptoms and is used in guidelines to guide treatment choice.
How it is calculated
SCORAD = A/5 + 7B/2 + C, range 0–103.
A — affected area, % (rule of nines; in children under 2 the head is larger and the legs smaller), 0–100.
B — sum of six signs, each 0–3, on a representative area: erythema, oedema/papulation, oozing/crusts, excoriations, lichenification, dryness (on uninvolved skin), 0–18.
C — itch and sleep loss over the last 3 days and nights, each 0–10, 0–20.
Mark the affected zones on the body chart or type the area, grade the six signs (each grade has a sample picture) and set itch and sleep with sliders. From the date of birth, children under 2 get infant proportions automatically. The total, severity band and patient details print on one A4 page.
Questions and answers
What is the difference between SCORAD and oSCORAD?
oSCORAD leaves out itch and sleep loss (part C), so it depends less on the patient’s report; its maximum is 83 instead of 103.
Where should intensity be graded?
On an area of average intensity that is representative for the patient; dryness is graded on uninvolved skin.
What SCORAD is severe?
Above 50 points (objective SCORAD above 40).
References
European Task Force on Atopic Dermatitis. Severity scoring of atopic dermatitis: the SCORAD index. Dermatology. 1993;186(1):23–31.
Kunz B, Oranje AP, Labrèze L, et al. Clinical validation and guidelines for the SCORAD index: consensus report of the European Task Force on Atopic Dermatitis. Dermatology. 1997;195(1):10–19.
Oranje AP, Glazenburg EJ, Wolkerstorfer A, de Waard-van der Spek FB. Practical issues on interpretation of scoring atopic dermatitis: the SCORAD index, objective SCORAD and the three-item severity score. Br J Dermatol. 2007;157(4):645–648.
