EASI
The Eczema Area and Severity Index (EASI; Hanifin et al., 2001) is a clinician-rated score of how much skin Atopic Dermatitis covers and how severe it is. The body is split into four regions: head/neck, trunk, upper limbs and lower limbs. Each region gets an area score from 0 to 6, based on the percentage of that region affected. It also gets an average intensity score for four signs, each 0–3: redness, thickness/swelling, scratching (excoriation) and Lichenification. For each region, the sum of the four signs is multiplied by the area score and then by a regional multiplier. The four results are added, giving a total of 0–72. Unlike SCORAD, EASI scores no dryness and no symptoms, so it measures only visible inflammation (DermNet).
EASI [defines] Atopic Dermatitis EASI [relates] Lichenification
Toddler adjustment. A young child’s head makes up a larger share of body surface and the legs a smaller share. For children aged 0–7 years, the head/neck multiplier is therefore ×0.2 instead of ×0.1, and the lower-limb multiplier is ×0.3 instead of ×0.4. Trunk (×0.3) and upper limbs (×0.2) are unchanged. EASI is the only one of the four scores here with an age-specific formula built in for toddlers. Scoring it takes a few minutes and some training, so it is a clinic and research tool rather than one for parents.
Severity bands. The first interpretation guide was Leshem et al. (BJD 2015). It was a retrospective study of paediatric and adult patients, anchored to the Investigator’s Global Assessment. It recommended 0 clear, 0.1–1.0 almost clear, 1.1–7.0 mild, 7.1–21.0 moderate, 21.1–50.0 severe, 50.1–72.0 very severe (κ = 0.75), and found EASI took about 6 minutes for a trained assessor (PubMed abstract). Chopra et al. (BJD 2017) re-tested the bands in adolescents and adults only and proposed 0 clear, 0.1–5.9 mild, 6.0–22.9 moderate, 23.0–72 severe (κ = 0.69). The Leshem figures previously quoted here from secondary sources match the primary abstract. Leshem included children, but neither paper reports bands validated specifically in 1–4-year-olds.
Conflict: [Leshem et al., BJD, 2015 — paediatric + adult, primary abstract] puts EASI mild/moderate at 7 and moderate/severe at 21, with extra “almost clear” and “very severe” bands. [Chopra et al., BJD, 2017 — adolescents/adults] puts them at 6 and 23 in four bands. Neither was derived in 1–4-year-olds. Unresolved — add to open_questions.
Skin of colour. Redness is one of EASI’s four signs. On brown and black skin, inflammation shows as violaceous, grey or dark-brown, so the redness item and the total can be under-scored. Some experts suggest scoring erythema one level higher in skin of colour (Sarkar et al., IJD 2026). See Eczema in Skin of Colour.
Eczema in Skin of Colour [relates] EASI
HOME core outcome. In 2014 the HOME Initiative reviewed 16 instruments for clinical signs. Only EASI and objective SCORAD were extensively validated, and an international consensus of patients, physicians, nurses, methodologists and industry chose EASI as the single core instrument for clinical signs in all eczema trials (Schmitt et al., 2014). HOME recommends pairing it with POEM for symptoms, IDQoL/CDLQI for quality of life, and RECAP or ADCT for long-term control (HOME VII, 2021). Many trials in this vault use EASI as their main outcome, for example the Bleach Baths meta-analyses and the Colloidal Oatmeal RCT.
HOME Initiative [supports] EASI EASI [relates] POEM
Connections
- Atopic Dermatitis — severity measure, source: DermNet EASI
- Bleach Baths — primary outcome in bleach bath meta-analyses, source: Chopra 2017; Bakaa 2022
- HOME Initiative — core instrument for clinical signs, source: Schmitt 2014
- POEM — HOME-paired symptom instrument, source: HOME VII 2021
- SCORAD — the other extensively validated signs score, source: Schmitt 2014
- Colloidal Oatmeal — EASI outcome in paediatric non-inferiority RCT, source: vault note
- Eczema in Skin of Colour — redness item under-scored on darker skin, source: Sarkar 2026