Product of Investigator Global Assessment and body surface area (IGAxBSA): a practice-friendly alternative to the Eczema Area and Severity Index (EASI) to assess atopic dermatitis severity in children

Abstract Background Accurately documenting pediatric atopic dermatitis (AD) severity is important, but research tools, such as Eczema Area and Severity Index (EASI), are too time-consuming for clinical settings. Product of the Physician Global Assessment and affected percentage of body surface area (PGAxBSA) is a new, rapid measure of psoriasis severity. Objective Evaluate an Investigator Global Assessment (IGA) and body surface area product (IGAxBSA) as an easy-to-use severity measure for pediatric AD. Methods Patient-reported and objective disease severity measures were collected from 195 caretaker/child dyads aged 5-17 with almost clear (validated Investigator Global Assessment, vIGA=1) to severe (vIGA=4) AD. Data was assessed using Spearman coefficients and plots. Severity strata were proposed using an anchoring approach based on EASI. Results IGAxBSA correlates better with EASI than IGA alone (r=0.924 vs. r=0.757, p Limitations Patient cohort was predominantly from the Midwestern United States. Conclusions IGAxBSA (using the validated IGA/vIGA) is a simple measure that correlates well with EASI in mild-to-severe pediatric AD. Future work is needed to affirm reliability across IGA scales and responsiveness to change.