Quality of Life Research

, 15:1551 | Cite as

CDLQI, Scorad and Ness: Are they Correlated?

  • K.L.E. Hon
  • W.Y.C. Kam
  • M.C.A. Lam
  • T.F. Leung
  • P.C. Ng



Quality of life (QOL) and clinical severity scores are important parameters in the evaluation of distress experienced by children with atopic dermatitis (AD). The SCORing Atopic Dermatitis (SCOARD) is a widely used clinical score for assessing AD symptomatology over the preceding 3 days and the Nottingham Eczema Severity Score (NESS) is another score useful for AD symptoms over the preceding 12 months.


We evaluated if these parameters are correlated with QOL in children with AD.


We assessed quality of life, clinical scores, total IgE and eosinophil count in peripheral blood in AD patients at our paediatric dermatology clinic over a 14-month period.


Eighty AD patients (42 males and 38 females; mean [SD] age 11.7 [3.7] years) were recruited. The median (interquartile range, IQR) IgE, eosinophil counts and eosinophil percentage were 2988 (1069–7847) kIU/L; 0.6 (0.4–0.9) × 10−9/L; and 9 (6–12)%, respectively. Quality of life as measured with CDLQI (The Children’s Dermatology Life Quality Index) generally did not correlate well with both the acute and chronic AD severity scores (objective SCORAD and total CDQLI, ρ = 0.17, p > 0.05; total NESS and total CDQLI, ρ = 0.29, p < 0.05). Factor analysis further confirmed that the objective indicators (serum total IgE, eosinophil count and objective SCORAD), self-reported scores (NESS and subjective SCORAD) and CDLQI were separate dimensions in the assessment of AD in children.


Quality of life, disease severity scores and laboratory atopic markers represent different domains in AD assessment. They do not necessarily correlate well with each other and all three aspects must be individually evaluated to assess the well-being of these patients.


Atopic dermatitis CDLQI Children Factor analysis NESS Quality of life SCORAD 


  1. 1.
    Charman C, Williams H (2000) Outcome measures of disease severity in atopic eczema. Arch Dermatol 136:763–769PubMedCrossRefGoogle Scholar
  2. 2.
    Charman C, Chambers C, Williams H (2003) Measuring atopic dermatitis severity in randomized controlled clinical trials: What exactly are we measuring? J Invest Dermatol 120:932–941PubMedCrossRefGoogle Scholar
  3. 3.
    Severity scoring of atopic dermatitis: The SCORAD index (1993) Consensus report of the european task force on atopic dermatitis. Dermatology 186:23–31CrossRefGoogle Scholar
  4. 4.
    Rees JL, Laidlaw A. (1999) Pruritus: More scratch than itch. Clin Exp Dermatol 24:490–493PubMedCrossRefGoogle Scholar
  5. 5.
    Kunz B, Oranje AP, Labreze L et al. (1997) Clinical validation and guidelines for the SCORAD index: Consensus report of the European Task Force on Atopic Dermatitis. Dermatology 195:10–19PubMedGoogle Scholar
  6. 6.
    Hon KL, Leung TF, Fok TF, et al. Subjective symptoms do not correlate well with disease extent or intensity in children with atopic dermatitis: PA-22. Br J Dermatol Suppl 2005; 153(Suppl 1): 89.Google Scholar
  7. 7.
    Chuh AA (2003) Validation of a Cantonese version of the Children’s Dermatology Life Quality Index. Pediatr Dermatol 20:479–481PubMedCrossRefGoogle Scholar
  8. 8.
    Ben Gashir MA, Seed PT, Hay RJ (2002) Are quality of family life and disease severity related in childhood atopic dermatitis? J Eur Acad Dermatol Venereol 16:455–462PubMedCrossRefGoogle Scholar
  9. 9.
    Ben Gashir MA (2003) Relationship between quality of life and disease severity in atopic dermatitis/eczema syndrome during childhood. Curr Opin Allergy Clin Immunol 3:369–373PubMedCrossRefGoogle Scholar
  10. 10.
    Ben Gashir MA, Seed PT, Hay RJ (2004) Quality of life and disease severity are correlated in children with atopic dermatitis. Br J Dermatol 150:284–290PubMedCrossRefGoogle Scholar
  11. 11.
    Emerson RM, Charman CR, Williams HC (2000). The Nottingham Eczema Severity Score: Preliminary refinement of the Rajka and Langeland grading. Br J Dermatol 142:288–297PubMedCrossRefGoogle Scholar
  12. 12.
    Lewis-Jones MS, Finlay AY (1995). The Children’s Dermatology Life Quality Index (CDLQI): Initial validation and practical use. Br J Dermatol 132:942–949PubMedCrossRefGoogle Scholar
  13. 13.
    Hanifin JM, Rajka G (1980) Diagnostic features of atopic dermatitis. Acta Derm Venereol (Stockh) 2:44–47Google Scholar
  14. 14.
    Hon KL, Ma KC, Wong E et al. (2003) Validation of a self-administered questionnaire in Chinese in the assessment of eczema severity. Pediatr Dermatol 20:465–469PubMedCrossRefGoogle Scholar
  15. 15.
    Hon KL, Leung TF, Ma KC et al. (2004) Urinary leukotriene E4 correlates with severity of atopic dermatitis in children. Clin Exp Dermatol 29:277–281PubMedCrossRefGoogle Scholar
  16. 16.
    Multivariate methods. In: Armitage P, Berry G, Matthews JN (eds), Statistical Methods in Medical Research. Oxford, UK: Blackwell Science 2002: 455–484.Google Scholar
  17. 17.
    Stevens J. (1996) Exploratory and confirmatory factor analysis. In: Stevens J, (eds) Applied Multivariate Statistics for the Social Sciences. Mahwah, NJ, Lawrence Erlbaum Associates, pp. 362–428Google Scholar
  18. 18.
    Cattell RB (1966). The Scree test for the number of factors. Multivariate Behav Res 1:245–276CrossRefGoogle Scholar
  19. 19.
    Leung TF, Ma KC, Hon KL et al. (2003) Serum concentration of macrophage-derived chemokine may be a useful inflammatory marker for assessing severity of atopic dermatitis in infants and young children. Pediatr Allergy Immunol 14:296–301PubMedCrossRefGoogle Scholar
  20. 20.
    Hon KL, Leung TF, Ma KC et al. (2004) Serum levels of cutaneous T-cell attracting chemokine (CTACK) as a laboratory marker of the severity of atopic dermatitis in children. Clin Exp Dermatol 29:293–296PubMedCrossRefGoogle Scholar
  21. 21.
    Hon KL, Lam MC, Leung TF, et al. Nocturnal wrist movements are correlated with objective clinical scores and plasma chemokine levels in children with atopic dermatitis. Br J Dermatol 2006; 154: 629–635Google Scholar
  22. 22.
    Hon KL, Leung TF, Ma KC et al. (2005) Resting energy expenditure, oxygen consumption and carbon dioxide production during sleep in children with atopic dermatitis. J Dermatolog Treat 16:22–25PubMedCrossRefGoogle Scholar
  23. 23.
    Leung TF, Wong GW, Ko FW, et al. (2005) Clinical and atopic parameters and airway inflammatory markers in childhood asthma: a factor analysis. Thorax 60:822–826PubMedCrossRefGoogle Scholar
  24. 24.
    Juniper EF, Wisniewski ME, Cox FM et al. (2004) Relationship between quality of life and clinical status in asthma: A factor analysis. Eur Respir J 23:287–291PubMedCrossRefGoogle Scholar
  25. 25.
    Tantisira KG, Litonjua AA, Weiss ST et al. (2003) Association of body mass with pulmonary function in the Childhood Asthma Management Program (CAMP). Thorax 58:1036–1041PubMedCrossRefGoogle Scholar
  26. 26.
    Hon KL, Leung TF, Wong Y, Ma KC, Fok TF (2004). Skin diseases in Chinese children at a pediatric dermatology center. Pediatr Dermatol 21:109–112PubMedCrossRefGoogle Scholar

Copyright information

© Springer 2006

Authors and Affiliations

  • K.L.E. Hon
    • 1
    • 2
  • W.Y.C. Kam
    • 1
  • M.C.A. Lam
    • 1
  • T.F. Leung
    • 1
  • P.C. Ng
    • 1
  1. 1.Department of PaediatricsThe Chinese University of Hong KongShatin, Hong Kong SARChina
  2. 2.Dermatology Research CenterThe Chinese University of Hong KongShatin, Hong Kong SARChina

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