Diagnosing and Assessing Atopic Dermatitis: Tools, Scoring Systems, and Patient-Centered Goal Setting

Welcome back to another AJMC Insights series. In this episode titled, 'Diagnosing and Assessing Atopic Dermatitis: Tools, Scoring Systems, and Patient-Centered Goal Setting,' Angela Lamb led the conversation about the following questions:

How are you approaching the initial diagnosis and severity assessment of atopic dermatitis (AD) in your practice today, and what tools or scoring systems are you relying on most?

How are you getting to the bottom of what is bothering patients and how are you setting goals for patients?

Are itch scores and skin assessment being evaluated separately, or as a composite?

How does that distinction affect treatment decisions?

Angela Lamb discussed the importance of taking a thorough patient history at initial presentation, including prior treatments and previous provider experiences, noting that most patients seen at a tertiary medical center have already tried multiple therapies without adequate relief. She highlighted the use of scoring tools such as the Eczema Area and Severity Index (EASI) score and the Investigator Global Assessment (IGA) to assess disease severity, while acknowledging that standardized digital assessment workflows are still being developed and implemented in many practices. Dr. Lamb emphasized the value of directly asking patients about their personal goals, whether better sleep, reduced itch, or improved appearance, and explained how body surface area (BSA) involvement and quality of life impact together guide treatment decisions, from non-steroidal topicals for mild disease to injectables and oral agents for more extensive or quality of life-impairing disease. She also noted that while itch and skin disease burden are assessed separately, significant overlap exists between the two, with itch typically driving patient distress and prompting the clinical visit.

Throughout the conversation, the expert provided a comprehensive reflection on the field and the factors that may shape how clinicians approach care moving forward.

In the next episode, 'Tracking Progress and Bridging Guideline Gaps in Atopic Dermatitis Care,' the panelist continues their discussion on atopic dermatitis and highlight real-world approaches to monitoring patients and capturing patient-reported outcomes, as well as where current guidelines fall short in providing clinicians with clear, actionable direction.