Validation of a clinical evaluation score for irritative dermatitis: SCOREPI

Background  Most dermatological conditions can be evaluated using validate clinical scores, no such tool is available for irritant contact dermatitis (ICD). Objective  To create and validate a grid-based ICD severity score. Methods  Three dermatologists developed the SCOre de REparation de l’EPIderme (SCOREPI) grid. Two studies were conducted to validate the SCOREPI. A cross-sectional study assessed the intra- and inter-observer error associated with using the SCOREPI. Each investigator received 15 min of training on proper use of the SCOREPI. A computer displayed a series of 20 photos of ICD, each of which were repeated three times in a randomized order. The prospective study assessed the correlation between SCOREPI with the severity of clinical symptoms as well as the sensitivity of the score to changes in ICD in response to topical treatment. Results  The SCOREPI took an average of 35 ± 5 s to be completed and was characterized by an excellent intra-observer and moderate inter-observer reproducibility (intra-class correlation coefficient = 0.93 and 0.74, respectively). Significant divergence was observed between the physicians’ assessment of estimated surface (P = 0.04), the presence of erythema (P < 0.0001) and the number of deep cracks (P = 0.0008). In the prospective analysis of patients, SCOREPI was correlated with tightness (r = 0.45; P < 0.0001), pain (r = 0.45; P < 0.0001), burning (r = 0.42; P < 0.0001), and pruritus (r = 0.28; P = 0.0055). SCOREPI decreased considerably during follow-up from 10.45 ± 4.61 to 4.82 ± 4.15 (P < 0.0001). Conclusion  The SCOREPI is easy to use, sensitive to change, and characterized by high intra- and moderate inter-observer reliability.