Objective measurement of two clinical signs in childhood atopic eczema in research and therapeutics

Abstract

Background: Atopic dermatitis (AD) or eczema is an inflammatory skin disease associated with significant impairment of quality of life. It is important to objectively quantify cutaneous biophysical measurements in research and therapeutics of this disease.Objective: To evaluate if skin redness (erythema) and pigmentation (melanin) correlate with disease severity and quality of life.Methods: Redness and pigmentation were measured under standardized condition at the antecubital flexure. Nottingham Eczema Severity Score (NESS) and Children’s Dermatology Life Quality Index (CDLQI) were documented.Results: Pigmentation correlated with age (r = 0.38, p = 0.02), but not with disease severity (NESS) or quality of life (CDLQI). Erythema correlated with age (r = 0.53, p = 0.001), NESS (r = 0.44, p = 0.006), pigmentation (r = 0.62, p< 0.0001), but not CDLQI (r = 0.3, trend p = 0.087).Conclusions: Skin erythema and pigmentation increase with age. Erythema correlates with disease severity but pigmentation correlates with neither severity nor quality-of-life score. The objective measurement of these two signs does not replace the clinical measurements of severity and quality of life, and may be of limited scope in eczema research and therapeutics.