الفهرس 
Atopic dermatitis
ORIGINAL ARTICLEOnly 14 pages are availabe for public view
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Abstract
There are no available laboratory tests for most dermatological disease either to establish the diagnosis or to monitor the severity of the condition. In practice clinicians relay upon clinical assessments of severity, sometimes supplemented by photographs kept in the patient’s medical record., also no instruments for the assessment of the severity of dermatological disease has achieved widespread acceptance or the use in the dermatological literature.
The principles of evidence-based medicine are used increasingly in dermatology to guide clinical practice and resource allocation. The production of therapy guidelines, compendiums of evidence, and systematic reviews is dependent on comparison of data from many different sources, and is hindered by wide variations in trial methodology.
Classification systems, a standard grading systems is often essential to perform research, analyze results, and compare data from different sources, and in turn provides a common reference for diagnosis, standard treatment, and assessment of results in clinical practice. Parameters and terminology also facilitate clear communication among a broad range of basic, clinical, and other researchers; practicing dermatologists and other specialists; health and insurance administrators; and patients and the general public.
Scoring systems would support further development as a research tool for a simple assessment of disease severity that could be used in epidemiological studies. Further validation is required, administration by researchers/health professionals and development as a wholly questionnaire-based assessment.
Scoring system often involve combination of disease surface area measurement and disease parameters assessment.
The surface area is usually measured by the Walla’s rule of nine, and the skin lesions are either counted, or graded; mild, moderate and sever, then each parameter is given numerical value to form a scoring system.
Presently available means cannot make scoring systems absolutely objective, however, the use of computerized digital image analysis for measuring the extent of the disease, may make the scoring system even more objective and may further improve its accuracy. This can eliminate the inter-observer variation, but this is usually available in specialized research centers and not in clinics.
A completely new dimension in scoring disease severity and efficacy of therapy has been introduced with the application of measures for quality of life (QOL) as the definition of a mild, moderate, severe concluded the BSA involvement alone inadequately measure disease severity and QOL standard would be better to define severity of the disease, and that there is no significant correlation between QOL and overall area involvement , although there is a significant correlation between QOL and involvement of visible sites . Measures for QOL are almost always self-report questionnaires.
In conclusion any scoring system to be useful, the outcome variables must be clearly defined, as objectively as is possible and should have adequate clinical and biological significance. A reliable, sensitive, and rapid evaluation method is essential for every busy dermatologic clinic. A preferred evaluation system will enable a better choice of the mode of therapy (local, systemic) for the skin disease, a better follow up of the therapeutic protocol and the better compliance with strict control of medical insurers with regard to remission period and cost effectiveness