SCORAD

Author: Dr Amanda Oakley, Dermatologist, Hamilton, New Zealand, 2009.


SCORAD is a clinical tool used to assess the extent and severity of eczema (SCORing Atopic Dermatitis). Dermatologists may use this tool before and after treatment to determine whether the treatment has been effective.

Area

To determine extent, the sites affected by eczema are shaded on a drawing of a body. The rule of 9 is used to calculate the affected area (A) as a percentage of the whole body.

  • Head and neck 9%
  • Upper limbs 9% each
  • Lower limbs 18% each
  • Anterior trunk 18%
  • Back 18%
  • 1% for genitals.

The score for each area is added up. The total area is 'A', which has a possible maximum of 100%.

Intensity

A representative area of eczema is selected. In this area, the intensity of each of the following signs is assessed as none (0), mild (1), moderate (2) or severe (3).

  • Redness
  • Swelling
  • Oozing / crusting
  • Scratch marks
  • Skin thickening (lichenification)
  • Dryness (this is assessed in an area where there is no inflammation)

The intensity scores are added together to give 'B' (maximum 18).

Atopic dermatitis : SCORAD intensity scoring

IntensityNoneMildModerateSevere
Redness atopic red 0
Score 0
atopic red 1
Score 1
atopic red 2
Score 2
atopic red 3
Score 3
Swelling atopic swollen 0
Score 0
atopic swollen 1
Score 1
atopic swollen 2
Score 2
atopic swollen 3
Score 3
Oozing / crusting atopic oozy 0
Score 0
atopic oozy 1
Score 1
atopic oozy 2 copy2
Score 2
atopic oozy 3
Score 3
Scratch marks atopic excoriation 0
Score 0
atopic excoriation 1
Score 1
atopic excoriation 2
Score 2
atopic excoriation 3
Score 3
Skin Thickening (Lichenification) atopic lichenification 0
Score 0
atopic lichenification 1
Score 1
atopic lichenification 2
Score 2
atopic lichenification 3
Score 3
Dryness dryness 1
Score 0
dryness 2
Score 1 
dryness 3
Score 2 
dryness 4
Score 3

Subjective symptoms

Subjective symptoms i.e., itch and sleeplessness, are each scored by the patient or relative using a visual analogue scale where 0 is no itch (or no sleeplessness) and 10 is the worst imaginable itch (or sleeplessness). These scores are added to give 'C' (maximum 20).

Total score

The SCORAD for that individual is A/5 + 7B/2 + C

 

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