SCORAD Index Calculator — Atopic Dermatitis Severity
The Severity Scoring of Atopic Dermatitis (SCORAD) index is a validated clinical tool for assessing atopic dermatitis (eczema) severity in both children and adults. It incorporates extent of disease (rule of nines), intensity of six clinical signs, and subjective symptoms.
About
The SCORAD index was developed by the European Task Force on Atopic Dermatitis (ETFAD) in 1993 as a standardized method for assessing atopic dermatitis severity. It combines three components: A (extent, 0-100), B (intensity, 0-18), and C (subjective symptoms, 0-20). The intensity component evaluates six clinical signs each scored 0-3: erythema, edema/papulation, oozing/crusting, excoriation, lichenification, and dryness (assessed on representative skin without excoriation or crusting). The subjective component uses a 10cm visual analogue scale for pruritus and sleep loss over the preceding 3 days. The SCORAD has been validated across multiple populations and is the most widely used severity scoring system for atopic dermatitis in clinical trials worldwide.
Formula
SCORAD = A/5 + 7B/2 + C
SCORAD = A/5 + 7B/2 + C, where A = extent (0-100, rule of nines), B = intensity (0-18, sum of six items each scored 0-3: erythema, edema/papulation, oozing/crusting, excoriation, lichenification, dryness), and C = subjective symptoms (0-20, pruritus VAS 0-10 + sleep loss VAS 0-10). Total range 0-103.
Score Interpretation
SCORAD is the most widely used atopic dermatitis severity score in clinical trials worldwide. The minimal clinically important difference (MCID) for SCORAD is approximately 8.4-10.2 points. SCORAD 50 (≥50% reduction) is commonly used as a treatment response threshold.
Mild — 0–24.9
Mild atopic dermatitis.
Management: Emollients and mild topical corticosteroids.
Moderate — 25–50
Moderate atopic dermatitis.
Management: Medium-potency topical corticosteroids and calcineurin inhibitors.
Severe — 50.1+
Severe atopic dermatitis.
Management: High-potency corticosteroids, systemic therapy, or phototherapy.
Reference Ranges
| Population | Normal Range | Notes |
|---|---|---|
| Atopic dermatitis patients | 0 (no disease) to 103 (maximal severity) | < 25 mild, 25-50 moderate, > 50 severe |
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A child with extent 40%, erythema 2, edema 2, oozing 1, excoriation 2, lichenification 1, dryness 1, pruritus 7, sleep loss 5. SCORAD = 40/5 + 7×(9)/2 + 12 = 8 + 31.5 + 12 = 51.5 (severe).
Related Conditions
Related Medications
Common Mistakes
Scoring dryness on excoriated skin where it cannot be assessed.
Dryness should be assessed on unaffected skin, not on excoriated or crusted areas.
Frequently Asked Questions
What is the difference between SCORAD and EASI?
References
- European Task Force on Atopic Dermatitis. Severity scoring of atopic dermatitis: the SCORAD index. Dermatology. 1993;186(1):23-31.