Validation of Head and Neck EASI Severity Strata Against vIGA-AD in Atopic Dermatitis.

Authors

Amalie Thorsti Møller Rønnstad, Yuki M F Andersen, Ann Hærskjold, Marianne Baastrup Søndergaard, Mia-Louise Nielsen, Katrine Elisabeth Karmisholt, Anne Birgitte Simonsen, Anne G Danielsen, Gitte Strauss, Luise W Idorn, Marianne Hald, Kristian Kofoed, Rikke Skøt Cvetkovski, Elisabeth Ammitzbøll, David Mølenberg, Hans Christian Ring, Lotte Themstrup, Charlotte G Mortz, Mette Deleuran, Claus Zachariae, Christian Vestergaard, Simon Francis Thomsen, Alexander Egeberg, Kristina S Ibler, Jacob P Thyssen

Published in

Dermatitis : contact, atopic, occupational, drug. Pages 17103568261496163. Oct 16, 2026. Epub Oct 16, 2026.

Abstract

Head-and-neck (H&N) Eczema Area and Severity Index (EASI) sub-scores are increasingly reported, but their clinical interpretation relative to the validated Investigator Global Assessment for Atopic Dermatitis (vIGA-AD) remains unclear.
Define H&N EASI severity strata anchored to vIGA-AD and evaluate convergent validity and interrater reliability.
Twenty-two dermatologists evaluated photographs of 21 patients with H&N AD using the H&N EASI and vIGA-AD. H&N EASI severity strata were derived based on the empirical distribution within vIGA-AD. Kendall's tau (τ) and Spearman's correlation coefficient (SCC) assessed convergent validity, and intraclass correlation coefficients (ICC) evaluated interrater reliability.
H&N EASI scores aligned with vIGA-AD (0, "Clear"; 0.1-0.6, "Almost clear"; 0.7-1.7, "Mild"; 1.8-3.0, "Moderate"; and 3.1-4.8, "Severe"), showing almost perfect agreement (weighted Cohen's κ = 0.83 [95% CI, 0.80-0.86], P < 0.001). H&N EASI and vIGA-AD scores were strongly correlated (τ = 0.74 [95% CI, 0.71-0.77]; SCC = 0.86 [95% CI, 0.83-0.88], both P < 0.001). Interrater reliability was moderate for H&N EASI (0.73 [95% CI, 0.60-0.85]) and vIGA-AD (0.61 [95% CI, 0.46-0.77]) (both P < 0.001).
H&N EASI severity strata provide a reliable and clinically meaningful assessment of H&N AD, aligning with facial vIGA-AD and enabling evaluation beyond global assessment.

PMID:
42888170
Bibliographic data and abstract were imported from PubMed on 17 Oct 2026.

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