EASI for clinical signs
The Eczema Area and Severity Index (EASI) is a validated scoring system that grades the physical signs of atopic dermatitis/eczema. EASI is the core outcome for measuring the clinical signs of eczema in all trials. For details of how this consensus was reached please click here.
Using EASI for non-commercial/academic purposes is unlikely to require a license fee, but commercial use may do. Please contact Wiley directly on firstname.lastname@example.org to confirm.
We are interested to know how it is being used, so we would appreciate it if you could email us if you are planning to use EASI.
This document contains the EASI scoring system (including instructions, diagrams, guidance and a frequently asked question section).
EASI Scoring table: for under 8's
| aged 8 and over
Frequently asked questions (Click to expand)
Can I alter the wording/adapt EASI?
We do not advise making any changes to the wording of EASI as this is likely to change its validity. Alterations to the layout/presentation (e.g. addition of trial logos or for use on a tablet / phone) is permitted.
Are there any translations of EASI available?
We are not aware of any translations available, but if you do translate EASI, we recommend you follow this guidance:
1. The text should be translated by 2 or more people who are:
a. Fluent in both the language EASI is being translated into and English
b. Familiar with the locality where the outcome measure will be used
2. The questionnaires should be translated back into English by an independent translator. The back translated version should be approved as being appropriate by a native English speaker with dermatology experience.
The translation doesn’t need to be exact translation of the wording but the meaning should be retained. The translated version must have the same structure and logic as the original.
I work for/on behalf of an organisation which requires EASI to be translated into another language. What permissions are needed?
You do not need a license to translate EASI into another language. We are however keen to make translated versions of the scale available to others in the eczema research community, so we would appreciate it if those who create translations would send us a copy to us, and allow us to share it on this webpage (we will of course acknowledge your contribution). Note: We appreciate that some translation companies require permissions to be confirmed by email, so please do get in touch if this is the case.
This material is free to use, but please do email us if you are planning to use it.
This presentation details how to assess eczema severity using EASI and includes both photos and illustrations.
In this 17 minute video, Consultant Dermatologist Dr Eric Simpson gives detailed guidance in using the EASI scoring system.
A practical exercise. These powerpoint slides contain images of eczema of varying severity. A test slide scoring sheet
is available to record your EASI scores for the test images. The answers for the exercise are available here.
Publications on interpretability of the EASI score and how it relates to mild, moderate and severe disease:
EASI, (objective) SCORAD and POEM for atopic eczema: responsiveness and minimal clinically important difference. Allergy 2012 Jan. doi: 10.1111/j.1398-9995.2011.02719
What the EASI score tells us about the severity of atopic dermatitis - an interpretability study. Br J Dermatol 2015 Jan 12. doi: 10.1111/bjd.13662
Severity strata for Eczema Area and Severity Index (EASI), modified EASI, Scoring Atopic Dermatitis (SCORAD), objective SCORAD, Atoptic Dermatitits Severity Index and body surface area in adolescents and adults with atopic dermatitis. Br J Dermatol 2017. doi: 10.1111/bjd.15641
Publication on inter-rater reliability of clinician rated signs instruments in skin of colour:
A comparison study of clinician-rated atopic dermatitis outcome measures for intermediate to dark skin patients. Br J Dermatol 2016 Dec 23. doi:10.1111\bjd.15271