Eczema Area and Severity Index (EASI)

EASI is an investigator‑rated score quantifying atopic dermatitis severity by combining lesion intensity and affected body area 1 [Level II evidence].

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Head/neck redness
Head/neck thickness
Head/neck scratching (excoriation)
Head/neck lichenification
Percentage of head/neck affected
Upper limbs redness
Upper limbs thickness
Upper limbs scratching
Upper limbs lichenification
Percentage of upper limbs affected
Trunk redness
Trunk thickness
Trunk scratching
Trunk lichenification
Percentage of trunk affected
Lower limbs redness
Lower limbs thickness
Lower limbs scratching
Lower limbs lichenification
Percentage of lower limbs affected

Indications for Use

Used to quantify clinical signs of atopic dermatitis in trials and specialized care, especially when assessing treatment response and defining endpoints (EASI‑50/75/90). Supported as a core instrument for clinician‑reported signs by the HOME consensus 1 [Level I evidence]. Systematic reviews confirm strong validity, reliability, and sensitivity to change 2 [Level II evidence]; recommended for moderate–severe disease assessment and comparison across interventions.

Insights & Cautions

Start by noting it reliably captures objective clinical signs and is the HOME‑recommended core instrument with adequate validity and responsiveness 1 [Level I evidence]. It is observer‑dependent, time‑consuming, and shows high inter‑rater variability in some studies 2 [Level II evidence]. Sensitivity is good but floor effects limit use in mild disease 3 [Level II evidence]. Caution in skin of color due to limited validation 4 [Level III evidence].