SCORAD Calculator for Atopic Dermatitis
SCORAD Calculator for Atopic Dermatitis
SCORAD = A/5 + 7B/2 + C, running 0 to 103. Objective SCORAD drops C — the two patient-reported items — and runs 0 to 83. They are not interchangeable, and the 7B/2 coefficient is the one to check.
SCORAD index
A/5 + 7B/2 + C, 0–103Extent 40%; erythema 2, oedema 1, oozing 1, excoriation 2, lichenification 1, dryness 2; pruritus 6, sleep loss 4
Formula
A = extent, per cent of body surface by the rule of nines (0–100, contributing 0–20)
B = sum of six intensity items, each 0–3 (0–18, contributing 0–63)
C = pruritus + sleep loss, two visual analogue scales 0–10 (0–20)
Objective SCORAD = A/5 + 7B/2, dropping C — range 0–83
- the 7B/2 coefficient
- a multiplication AND a division, and the term most easily inverted. 7B/2 is 3.5 points per intensity point; 2B/7 would be 0.29. At B = 0 the two agree exactly, which is why checking the formula only at zero proves nothing. The independent confirmation is arithmetic: the eSCORAD site states the intensity term as a maximum of 63 points out of 103, and 18 × 7/2 is exactly 63 while 18 × 2/7 is 5.1
- A/5
- the extent term. A maximum extent of 100 per cent contributes 20 points, which is the figure eSCORAD prints for it. Extent is therefore under a fifth of the scale: SCORAD is dominated by intensity, not by area, which is the opposite of how PASI and EASI are built
- C
- pruritus and sleep loss, each on a 0 to 10 visual analogue scale averaged over the last three days and nights, contributing 1 point each per unit to a maximum of 20. These are the only patient-reported items in the index, and they are what objective SCORAD removes
- objective SCORAD is NOT a rescaled SCORAD
- it is SCORAD minus C, so its range is 0 to 83 and its severity strata are their own: mild below 15, moderate 15 to 40, severe 40 and above, from Wolkerstorfer and colleagues. Reading an objective SCORAD against the full SCORAD bands, or the reverse, misclassifies. Oranje and colleagues note an additional 10 bonus points in some renderings of the objective score, which this page does not apply
- the extent is a WHOLE-BODY percentage
- scored by the rule of nines, unlike EASI and PASI, which use a 0 to 6 category of each region separately. A number carried across from an EASI area field is not a SCORAD extent
- dryness is scored on uninvolved skin
- the six intensity items are graded on a representative area, but dryness is assessed where there is no inflammation. It is a measure of the barrier rather than of the flare, and it is the item most often scored in the wrong place
Worked example
Extent 40%; erythema 2, oedema 1, oozing 1, excoriation 2, lichenification 1, dryness 2; pruritus 6, sleep loss 4
A = 40, so A/5 = 8.0
B = 2 + 1 + 1 + 2 + 1 + 2 = 9, so 7B/2 = 7 × 9 / 2 = 31.5
C = 6 + 4 = 10.0
SCORAD = 8.0 + 31.5 + 10.0 = 49.5 points — moderate on the Almirall cut-offs of 25 to 50
Objective SCORAD = 8.0 + 31.5 = 39.5, which is moderate on its own strata of 15 to 40 and within half a point of the severe boundary at 40. The two scales do not move together
Check the coefficient in isolation: raise erythema from 2 to 3 and nothing else, and the total rises by exactly 3.5 to 53.0. If the coefficient had been written 2B/7 the rise would be 0.29 and the total would be 15.6
Set both visual analogue scores to 0 and the total falls to 39.5, which is the objective SCORAD — the two must agree, and that identity is the check that C has been subtracted and nothing else has
The three terms, and how much of the scale each owns
| Term | Raw range | Contribution | Share of 103 |
|---|---|---|---|
| A/5 — extent | 0 to 100% | 0 to 20 points | 19% |
| 7B/2 — six intensity items | 0 to 18 | 0 to 63 points | 61% |
| C — pruritus and sleep loss | 0 to 20 | 0 to 20 points | 19% |
| SCORAD | — | 0 to 103 | 100% |
| Objective SCORAD (A/5 + 7B/2) | — | 0 to 83 | 81% |
The severity strata, and the two published bandings that disagree
| Scale | Mild | Moderate | Severe | Source as read |
|---|---|---|---|---|
| SCORAD | Below 25 | 25 to 50 | Above 50 | Almirall severity-indices reference |
| SCORAD | 0 to 24 | 25 to 59 | 60 or above | eSCORAD site |
| Objective SCORAD | Below 15 | 15 to 40 | 40 or above | Wolkerstorfer et al., Acta Derm Venereol 1999 |
The one index that scores the patient as well as the skin
SCORAD is the consensus instrument of the European Task Force on Atopic Dermatitis, and it is built differently from PASI and EASI in two ways that matter. First, extent is a whole-body percentage scored by the rule of nines rather than a category of each region, so there is no regional weighting at all. Second, it includes two patient-reported items — pruritus and sleep loss, each on a 0 to 10 visual analogue scale over the previous three days and nights — which no clinician-scored signs index does. Those two features are why SCORAD and EASI can rank the same two patients in opposite orders.
The arithmetic is A/5 + 7B/2 + C. The weighting that falls out of it is worth noticing: extent contributes at most 20 points, the six intensity items at most 63, and the subjective pair at most 20, for a maximum of 103. So SCORAD is an intensity-weighted index in which area is under a fifth of the scale. The 7B/2 term is 3.5 points per intensity point, and it is the single term most easily got wrong, because it is a multiplication and a division that can be inverted: 2B/7 gives 0.29 points per intensity point and agrees with the correct form only at zero. The arithmetic check is that 18 intensity points must come to exactly 63, which is the figure published as the intensity term’s share.
Objective SCORAD is SCORAD with C removed, and it is a different instrument rather than a rescaling. Its range is 0 to 83 and its severity strata are its own — mild below 15, moderate 15 to 40, severe 40 and above. Trials prefer it because the two visual analogue scales are the least reproducible part of the index and because a drug cannot be blinded against a patient’s own report of itch; clinics often prefer the full score because the itch and the sleep loss are what the patient came about. Reading one against the other’s bands misclassifies, and this page therefore computes and labels both.
Two sources read for this page disagree on where the full SCORAD’s severe boundary sits — above 50 in one, 60 or above in the other — and both are printed. The rule-of-nines extent belongs to the burn TBSA calculator and is linked rather than rebuilt. No proprietor, licence portal or permission notice was found for this instrument; it is a journal-published scoring scheme, restated here with attribution rather than reproduced from a licensed questionnaire.
Frequently asked questions
What is the SCORAD formula?
SCORAD = A/5 + 7B/2 + C, where A is the extent as a percentage of body surface by the rule of nines, B is the sum of six intensity items each scored 0 to 3, and C is the sum of two visual analogue scales for pruritus and sleep loss. The maximum is 103: 20 from extent, 63 from intensity and 20 from the subjective items.
What is objective SCORAD and how does it differ?
Objective SCORAD is A/5 + 7B/2 — the full index with the two patient-reported items removed. Its range is 0 to 83 and its severity strata are its own: mild below 15, moderate 15 to 40, severe 40 and above. It is not a rescaled SCORAD and the two sets of bands are not interchangeable.
What SCORAD score is mild, moderate or severe?
Two published bandings disagree. The Almirall severity-indices reference gives mild below 25, moderate 25 to 50 and severe above 50. The eSCORAD site gives 0 to 24 mild, 25 to 59 moderate and 60 or above severe. A score of 55 falls in different classes on the two, and both are printed on this page.
Why is the intensity term multiplied by 3.5?
Because 7B/2 is 3.5 per intensity point, and that is what makes the intensity term worth up to 63 of the index’s 103 points. The coefficient is the term an implementation most easily inverts — 2B/7 would be 0.29 per point and agrees with the correct form only when B is zero — so it is worth checking that raising one intensity item by one point raises the total by exactly 3.5.
Can I use an EASI area score as the SCORAD extent?
No. SCORAD’s extent is a percentage of the WHOLE BODY by the rule of nines. EASI’s and PASI’s area figures are 0 to 6 categories of each region separately. The two are different quantities and substituting one for the other will give a number that looks plausible and is wrong.
Related calculators
References
- Stalder JF, Taieb A, Atherton DJ, et al; European Task Force on Atopic Dermatitis. Severity scoring of atopic dermatitis: the SCORAD index. Consensus report of the European Task Force on Atopic Dermatitis. Dermatology. 1993;186(1):23–31. doi:10.1159/000247298; PMID 8435513.
- DermNet. SCORAD — the formula A/5 + 7B/2 + C, the rule-of-nines extent, the six intensity items and the two subjective items. dermnetnz.org/topics/scorad
- Almirall. Índices de gravedad en dermatitis atópica, version 4, December 2025 — SCORAD = A/5 + 7B/2 + C with the severity cut-offs under 25, 25–50 and above 50, and the EASI adult multipliers. dermatologia.almirallmed.es
- Oranje AP, Glazenburg EJ, Wolkerstorfer A, de Waard-van der Spek FB. Practical issues on interpretation of scoring atopic dermatitis: the SCORAD index, objective SCORAD and the three-item severity score. Br J Dermatol. 2007;157(4):645–8.
- Wolkerstorfer A, de Waard van der Spek FB, Glazenburg EJ, Mulder PGH, Oranje AP. Scoring the severity of atopic dermatitis: three item severity score as a rough system for daily practice and as a pre-screening tool for studies. Acta Derm Venereol. 1999;79(5):356–9.
- eSCORAD — the SCORAD component maxima stated as points of the total (extent 20, intensity 63, subjective 20), oSCORAD 0–83 and SCORAD 0–103, with its own severity strata. escorad.dermavalue.com
- International Society of Atopic Dermatitis. Clinical practice tools — “the two founding papers of the SCORAD index are now in free access”. isad.org
Not medical advice. For healthcare professionals and education. Reference intervals vary by laboratory and assay — always use your own laboratory's. Never base a dose or a treatment decision on this page alone. Full disclaimer at calcengines.com/disclaimer/