Validated Investigator Global Assessment scale for Atopic Dermatitis

There is a tremendous need for accurate and reproducible scoring systems for skin disease grading to drive the development of research and standards of care. Currently, there are more than 60 methods that have been used to assess the severity of atopic dermatitis. These assessments vary considerably in content, scale, instructions, validity, and concordance (Chopra R et al. 2018).

The Investigator Global Assessment (IGA) is recommended by health authorities for drug approval in atopic dermatitis (AD). A 5-point IGA scale, including morphological descriptions, was developed by an expert panel to assess the severity of atopic dermatitis. The following parameters are recorded (Simpson E et al. 2020):

0 - Not affected: No inflammatory signs of atopic dermatitis (no erythema, no induration/infiltration, no lichenification, no oozing, no crusting). Postinflammatory hyperpigmentation and/or hypopigmentation may be present.

1 - Little affected: Barely noticeable erythema, barely noticeable induration/ raised area and/or minimal lichenification. No oozing, no crusting.

2 - Mild: Mild but noticeable erythema (pink), mild but noticeable induration/ raisedness and/or mild but noticeable lichenification. No oozing, no crusting.

3 - Moderate Distinctly noticeable erythema (dull red), distinctly noticeable induration/ raised area and/or distinctly noticeable lichenification. Oozing and crusting may be present.

4 - Severe Marked erythema (deep or bright red), marked induration/ elevation, and/or marked lichenification. The disease is widespread. Oozing or crusting may be present.

Excoriations are not considered in the evaluation of disease severity

1. Chopra R et al. (2018) Assessing the severity of atopic dermatitis in clinical trials and practice. Clin Dermatol 36:606-615.
2. Simpson E et al (2020) The Validated Investigator Global Assessment for Atopic Dermatitis (vIGA-AD): The development and reliability testing of a novel clinical outcome measurement instrument for the severity of atopic dermatitis. J Am Acad Dermatol 83:839-846.