A Comparison of Two Scoring Methods in Atopic Dermatitis

Cho, Soyun; Kim, Seong Hyun; Whang, Kyu Kwang; Hahm, Jeong Hee

Abstract

BACKGROUND
Scoring of atopic dermatitis has been a rather controversial issue in recent years, with scoring systems of varying complexity being advocated by different investigators.
OBJECTIVE
It was the aim of this study to compare two of the most commonly used scoring methods in a clinical setting.
METHODS
Fifty-eight patients diagnosed as having atopic dermatitis were evaluated using the Rajka & Langeland grade and the SCORAD, and the two scoring systems were compared with respect to the presence or absence of clinical and laboratory parameters of atopic dermatitis.
RESULTS
The patients were composed of 22 males and 36 females, with an average age of 7.1 years. The average Rajka & Langeland grade was 6.1 (maximum, 9) and the SCORAD, 42.6 (maximum, 103). In both systems, the majority of the patients belonged to the moderate group; however, there was a relatively poor agreement between the two scoring systems in the assessment of overall severity of atopic dermatitis (kappa = 0.267). The SCORAD was better cor- related with the clinical and laboratory parameters, such as associated diseases, family history, smoking of the mother, contact with animal and high IgE level.
CONCLUSION
The two scoring systems cannot be used interchangeably. The Rajka & Langeland grade is more ideal for quick, large surveys, and the SCORAD, for drug-effect studies or follow-up of progression of the disease. The SCORAD is the more useful system in relation to other clinical and laboratory aspects of atopic dermatitis.