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Comparison of eczema severity measures

Atopic eczema/dermatitis (“eczema”) causes dry and itchy skin, and people with eczema must moisturise regularly to replace water lost from their skin. We wanted to find out if we could do a clinical trial to compare different moisturisers (or emollients). As part of this study, we assessed their effectiveness in several different ways. This included a patient‐reported questionnaire called POEM; three different researcher‐completed assessments called EASI, SASSAD and TIS; and finally, we also used a device called a corneometer to assess the water content (or hydration) of the skin. POEM, EASI, SASSAD and TIS all recorded an improvement in the eczema of children taking part in the study, showing that regular moisturisation does improve the symptoms and signs of eczema. However, parent‐reported and researcher‐collected measures were not directly comparable, and the corneometer did not compare very well with any of the other measures. Overall, our findings support the recommendations of a group called HOME, who say that all clinical trials of treatments for eczema should include the measures POEM and EASI. We also think these types of measure are the best way to assess the effectiveness of moisturisers for people with eczema, rather than a corneometer. A follow‐on trial called Best Emollient for Eczema (BEE, www.bristol.ac.uk/bee-study), using POEM and EASI, will find out whether one type of emollient (lotion, cream, gel or ointment) is better than another.