C. Zhao, E.Y. Hao, D.D. Oh, B.S. Daniel, L.K. Martin4, J. Su, M. Rodrigues, D.F. Murrell
Introduction: Atopic dermatitis (AD) scores appeared unreliable in dark skinned patients in a previous study performed using photographs.1 We sought to improve the previous study by performing it in real-life patients and to investigate the reliability of a novel grey-scale for skin of colour patients.
Method: Twenty-four AD patients each attended a one-day scoring exercises based in either Sydney or Melbourne. Each patient was scored by 5 dermatology doctors using the Eczema Area Severity Index (EASI)2, objective-Scoring Atopic Dermatitis score (oSCORAD), Physician Global Assessment (PGA) and a grey-scale composed of four shades of grey. Patients self-completed the Dermatology Life Quality Index (DLQI) and the Patient-Oriented Eczema
Measure (POEM). A Mexameter was used for their baseline melanin indices. Twelve randomly-chosen patients were re-scored for intra-rater reliability. Reliability was analysed using the intra-class correlation coefﬁcient (ICC). The con- tribution of score components to their variability was anal- ysed with the co-efﬁcient of variance (CV).
Results: Preliminary data from the ﬁrst twelve patients seen in Sydney (6 with melanin index >200 indicating Asian/African skin types) showed that all scores had worse inter-rater reliability in dark patients. EASI had an ICC of
0.85 in light patients vs. 0.79 in dark patients, oSCORAD
0.84 in light patients vs. 0.78 in dark patients, and PGA
0.86 in light patients vs. 0.67 in dark patients. Intra-rater ICCs were excellent in all skin types. Full results including all 24 patients will be presented, showing contribution of score components to variability, correlation with QoL scores, and validation of the grey-scale.