RALEIGH, N.C. – The infra-auricular fissure present in the overwhelming majority of atopic dermatitis patients provides a simple and convenient guide to disease severity, according to the results of a prospective study.
Infra-auricular fissures are highly prevalent in atopic dermatitis patients of all ages and racial/ethnic groups and in both genders. And the form the lesion takes shows a good correlation with disease severity as measured with the Eczema Area and Severity Index (EASI) and other metrics, Dr. Gil Yosipovitch said at the annual meeting of the Society for Investigative Dermatology.
"I’m not saying this is an ideal test, but I think that it’s a very easy bedside marker that we could use in our clinics. We can’t use the EASI all the time in busy fast-track clinics," observed Dr. Yosipovitch, professor of dermatology at Wake Forest University in Winston-Salem, N.C.
He and his coinvestigators assigned an infra-auricular fissure score of 1 to atopic dermatitis patients with an infra-auricular line and a score of 2 in those with an infra-auricular line accompanied by erythema and a small fissure. Those patients with a deeper infra-auricular fissure with significant erosion got a 3.
An infra-auricular fissure was present in every one of 81 consecutive children and adults with clinician-diagnosed atopic dermatitis. Fifty-eight percent had an infra-auricular fissure score of 1, 27% had a 2, and 15% scored 3. The infra-auricular fissure score showed a strong correlation with results on the validated EASI, with a correlation coefficient of 0.6.
Moreover, among the 29 patients seen at follow-up 1-2 months later, reductions in visual analog scale itch intensity, EASI score, and Investigator Global Assessment scores in response to treatment showed a significant correlation with improvement in the infra-auricular fissure score.
Dr. Yosipovitch reported having no financial conflicts.