Validation of Head and Neck EASI Severity Strata Against vIGA-AD in Atopic Dermatitis
Background: 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. Objective: Define H&N EASI severity strata anchored to vIGA-AD and evaluate convergent validity and interrater reliability. Methods: 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. Results: 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). Conclusions: 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.
Authors
- Katrine Elisabeth Karmisholt (ORCID: https://orcid.org/0000-0001-8511-3634)
- Alexander Egeberg (ORCID: https://orcid.org/0000-0001-8257-1816)
- Jacob Pontoppidan Thyssen (ORCID: https://orcid.org/0000-0003-3770-1743)
- Simon Francis Thomsen (ORCID: https://orcid.org/0000-0002-4838-300X)
- Mette Sondergaard Deleuran (ORCID: https://orcid.org/0000-0003-0593-9925)
- Rikke Skøt Cvetkovski
- Lotte Themstrup (ORCID: https://orcid.org/0000-0003-1368-1522)
- Y.M.F. Andersen (ORCID: https://orcid.org/0000-0001-6131-2815)
- Hans Christian Ring (ORCID: https://orcid.org/0000-0002-6145-5549)
- Anne Birgitte Simonsen (ORCID: https://orcid.org/0000-0002-9299-0317)
- David Mølenberg
- Luise Winkel Idorn (ORCID: https://orcid.org/0000-0002-3732-9542)
- Christian Vestergaard (ORCID: https://orcid.org/0000-0001-6485-3158)
- Charlotte Gotthard Mortz (ORCID: https://orcid.org/0000-0001-8710-0829)
- Amalie Thorsti Møller Rønnstad (ORCID: https://orcid.org/0000-0001-9949-9726)
- Anne Danielsen (ORCID: https://orcid.org/0000-0003-1371-1533)
- Claus Otto Carl Zachariae (ORCID: https://orcid.org/0000-0001-5506-1319)
- Kristina Sophie Ibler (ORCID: https://orcid.org/0000-0002-5324-1591)
- Elisabeth Ammitzbøll
- Mia‐Louise Nielsen (ORCID: https://orcid.org/0000-0002-1562-8568)
- Marianne Hald (ORCID: https://orcid.org/0000-0001-9535-8846)
- Ann Hærskjold
- Gitte Strauss
- Kristian Kofoed
- Marianne Baastrup Søndergaard
Institutions
- University of Copenhagen (DK)
- University of Southern Denmark (DK)
- Odense University Hospital (DK)
- Bispebjerg Hospital (DK)
- Aarhus University Hospital (DK)
- Gentofte Hospital (DK)
- Zealand University Hospital (DK)
- Danish Centre for Marine Research (DK)
- Hudklinikken (DK)
Publication Details
- Journal
- Dermatitis
- Published
- 2026-10-16
- DOI
- https://doi.org/10.1177/17103568261496163
- Primary Topic
- Dermatology and Skin Diseases
- Type
- article
- Field-Weighted Citation Impact
- 0.00