POEM
The Patient-Oriented Eczema Measure (POEM; Charman, Venn & Williams, 2004) is a patient- or carer-reported score of eczema severity. It measures Atopic Dermatitis as the family experiences it, not as a clinician sees it. It asks seven questions about the past week: on how many days the skin was itchy, sleep was disturbed, skin bled, wept/oozed, was cracked, was flaky, and felt dry/rough. Each question is scored 0–4 by number of days (0 = none, 1 = 1–2 days, 2 = 3–4 days, 3 = 5–6 days, 4 = every day), giving a total of 0–28 (Nottingham CEBD).
POEM [defines] Atopic Dermatitis POEM [relates] Sleep Disturbance in Eczema
Severity bands (Nottingham CEBD): 0–2 clear/almost clear; 3–7 mild; 8–16 moderate; 17–24 severe; 25–28 very severe. These bands are part of the instrument and do not depend on age, unlike the borrowed adult cut-offs used for SCORAD and EASI. Two of the seven items cover itch and sleep loss, so POEM picks up the Itch-Scratch Cycle and its nightly toll directly. Signs-only scores like EASI miss these.
POEM [relates] Itch-Scratch Cycle
Who uses it, and the toddler version. POEM has a caregiver-reported (proxy) version that parents fill in on their child’s behalf. It has no lower age limit, which makes it the obvious tool for a 1–4-year-old. It is free for personal and non-commercial use, comes in dozens of approved translations, and is available as a digital calculator and the “My Eczema Tracker” app. NICE CG57 recommends grading severity and checking quality-of-life impact at each review, and suggests POEM alongside 0–10 itch and sleep scales (see Atopic Dermatitis). In practice, a parent can score POEM weekly at home and bring the trend to the GP or dermatologist, which is more reliable than recalling the past month from memory.
HOME core outcome. The HOME Initiative systematically reviewed 18 symptom instruments. POEM was the most extensively validated, with adequate internal consistency, construct validity and responsiveness. In 2015 HOME adopted it as the core instrument for patient-reported symptoms in all eczema trials, paired with EASI for clinician-rated signs. At HOME VII (Tokyo 2019, published 2021) the set was completed. Quality of life is measured with the IDQoL for infants, CDLQI for children and DLQI for adults. Long-term control uses RECAP or the ADCT. A peak-itch NRS-11 (past 24 h) was added on top of POEM, but only for adults and older children who can self-rate. POEM counts itch days but not itch intensity. Itch intensity has no validated measure for toddlers, so POEM is the main symptom measure at this age.
HOME Initiative [supports] POEM POEM [relates] EASI
Connections
- Atopic Dermatitis — parent-reported severity measure, source: Nottingham CEBD; NICE CG57
- HOME Initiative — core instrument for patient-reported symptoms, source: HOME VII 2021
- EASI — HOME-paired clinician signs instrument, source: HOME VII 2021
- SCORAD — clinician hybrid alternative, source: DermNet
- NICE CG57 — recommends POEM for severity monitoring, source: Nottingham CEBD
- Sleep Disturbance in Eczema — sleep disturbance is one of 7 items, source: Nottingham CEBD
- Itch-Scratch Cycle — itch frequency is one of 7 items, source: Nottingham CEBD
- Eczema in Skin of Colour — symptom-based score not dependent on seeing redness, source: Sarkar 2026
- BEE Trial — primary outcome, weekly POEM over 16 weeks, source: Ridd 2022