Canine Atopic Dermatitis Extent and Severity Index(CADESI)

Canine atopic dermatitis (CAD) severity is difficult to assess as only a few scoring systems have been developed. The most used is the Canine Atopic Dermatitis Extent and Severity Index (CADESI), adapted from the human SCORing Atopic Dermatitis (SCORAD). Despite wide use of this scoring system in clinical trials, no validation has been carried out to the authors’ knowledge. The aim of this study was to determine the reproducibility of the CADESI in clinical practice.
Initially, a set of 28 photographs taken from dogs diagnosed with CAD was scored by 6investigators for three items: erythema, lichenification and excoriation. Subsequently, 23 dogs with clinical signs compatible with CAD were graded by 2 investigators using the CADESI (erythema, lichenification and excoriation, having been assessed on 39 areas).
With the photographs, significant correlation (rS, p<0.05) was found for each combination of investigators for erythema and lichenification but only in 10/15 combinations for excoriation; interobserver agreement ranged between poor and fair (0.221These results suggest that erythema and lichenification are reproducible whereas excoriation is more difficult to assess. It seems also that assessment of severity varies depending on the area studied.