Quantifying Atopic Dermatitis in Practice: Evaluating Patient Disease Severity

EP: 1.Recognizing and Diagnosing Atopic Dermatitis With Confidence

EP: 2.A Practical Guide to Atopic Dermatitis Differential Diagnosis

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EP: 3.Quantifying Atopic Dermatitis in Practice: Evaluating Patient Disease Severity

EP: 4.Soothing the Skin: Wellness Practices for Atopic Dermatitis Management

EP: 5.The Topical Toolbox: A Review of Atopic Dermatitis Treatment Options

EP: 6.TCS and TCIs: Benefits, Risks, and Real-World Uses for Atopic Dermatitis

EP: 7.Beyond Steroids: Clinical Trial Results on the Next Generation Agents for Atopic Dermatitis

EP: 8.Tailoring Treatment: Personalizing Topical Therapy for Patients With Atopic Dermatitis

EP: 9.Stronger Together: Collaborating with Dermatologists for Better Outcome

EP: 10.Real Cases, Key Takeaways: Applying Atopic Dermatitis Insights in Clinical Practice

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Clinical assessment of atopic dermatitis severity relies on multiple measurement approaches, though most formal scoring systems remain primarily research tools rather than practical clinical instruments. Clinician-reported outcomes focus on measurable parameters including body surface area involvement and intensity factors such as erythema, scaling, swelling, and excoriation. Patient-reported outcomes capture crucial quality-of-life indicators including sleep quality, daily functioning, and itch severity scores. While comprehensive assessment tools like the Investigator Global Assessment (IGA) and various validated scales exist, their complexity and time requirements make them impractical for routine clinical use outside of research settings.

Practical severity assessment in clinical practice centers on key easily measurable parameters that provide meaningful treatment guidance. Body surface area calculation using the patient's palm (representing 1% BSA) or the rule of nines offers quick, reliable measurement techniques adapted from burn medicine. The IGA scale, ranging from 0 (clear) to 4 (severe), provides rapid visual assessment capabilities that experienced clinicians can perform efficiently. Itch scoring using a 0-10 numerical rating scale captures patient-reported symptom severity, recognizing that some patients may have limited BSA involvement but severe itching requiring aggressive treatment approaches comparable to extensive disease cases.

Location-specific impact assessment acknowledges that atopic dermatitis affecting visible or sensitive areas may disproportionately impact quality of life regardless of total body surface area involvement. Face, hands, feet, and private area involvement often requires more intensive treatment due to functional and psychosocial implications. Rather than relying on traditional mild-moderate-severe classifications, Dr. Song advocates for a practical binary approach: determining whether patients can be managed with topical therapies alone or require systemic intervention. This simplified assessment framework, combined with open-ended quality-of-life questions about specific functional limitations, provides clinically actionable information for treatment planning and monitoring therapeutic progress over time.