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How was the eSA-EASI developed?

The SA-EASI was developed at the Bowman Gray School of Medicine of Wake Forest University in the USA. The SA-EASI is a modified version of the original EASI, which requires trained staff for the measurement. However, whereas in the original version the physician is asked to assign the severity of the disease on a scale from 0 – 3 for each body part, the severity of an average lesion is marked by patients on visual analog scales (0 – 100) in the SA-EASI. Instead of the calculation of the involved Body Surface Area (BSA) by trained personnel, a line-drawing silhouette of the front and back is marked by the patient to estimate the involved body area. In the electronic version of the SAPASI, the body surface area is calculated using the patient's palm, with one palm representing approximately 1 % of the body surface area. Since its original development, the SA-EASI was validated in multiple studies and showed good agreement with the original and well accepted EASI. The electronic version of the SA-EASI is currently validated at the Institute for Health Services Research in Dermatology and Nursing at the University Medical Center Hamburg-Eppendorf.

The impact of eczema

Eczema is a skin condition characterized by patches of inflamed, itchy, red, cracked, and swollen skin. The term "eczema" and "dermatitis" are often used interchangeably, with the most commonly condition being atopic eczema/dermatitis. Atopic eczema is an inflammation of the dermal layer of the skin resulting in inflamed, red, sometimes blistered, and rough patches of skin.

The condition is chronic, prone to relapse, and often extremely pruritic. While the condition may occur at any age, it is most common in childhood and severity varies throughout the life cycle. The exact cause is unclear, but it is known to result from a combination of genetic (hereditary) and environmental factors.

Atopic eczema has a severely negative effect on quality of life (QoL), with patients reporting skin damage, soreness, sleep deprivation (due to itching), activity restriction and depression. The lifestyle burden cannot be underestimated with frequent doctor visits, special clothing and the need to constantly apply messy topical ointments adding to the patient distress. Children with severe cases tend to have a smaller social circle and participate in fewer group activities than their peers.

They are also at higher risk for developing depression, anxiety, and other mental health disorders. The burden is also carried by parents, who report of a lack of sleep and privacy (often due to co-sleeping), treatment-related financial expenditures, and feelings of hopelessness, guilt, and depression. It's estimated that parents of children with moderate to severe atopic eczema spend up to 3 hours a day caring for their children's skin.