CDLQI, SCORAD and NESS: are they correlated?

Background: Quality of life (QOL) and clinical severity scores are important parameters in the evaluation of distress experienced by children with atopic dermatitis (AD). The SCORing Atopic Dermatitis (SCOARD) is a widely used clinical score for assessing AD symptomatology over the preceding 3 days and the Nottingham Eczema Severity Score (NESS) is another score useful for AD symptoms over the preceding 12 months.

Objective: We evaluated if these parameters are correlated with QOL in children with AD.

Patients/methods: We assessed quality of life, clinical scores, total IgE and eosinophil count in peripheral blood in AD patients at our paediatric dermatology clinic over a 14-month period.

Results: Eighty AD patients (42 males and 38 females; mean [SD] age 11.7 [3.7] years) were recruited. The median (interquartile range, IQR) IgE, eosinophil counts and eosinophil percentage were 2988 (1069-7847) kIU/L; 0.6 (0.4-0.9) x 10(-9)/L; and 9 (6-12)%, respectively. Quality of life as measured with CDLQI (The Children's Dermatology Life Quality Index) generally did not correlate well with both the acute and chronic AD severity scores (objective SCORAD and total CDQLI, rho = 0.17, p > 0.05; total NESS and total CDQLI, rho = 0.29, p < 0.05). Factor analysis further confirmed that the objective indicators (serum total IgE, eosinophil count and objective SCORAD), self-reported scores (NESS and subjective SCORAD) and CDLQI were separate dimensions in the assessment of AD in children.

Conclusion: Quality of life, disease severity scores and laboratory atopic markers represent different domains in AD assessment. They do not necessarily correlate well with each other and all three aspects must be individually evaluated to assess the well-being of these patients.