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HECSI is a clinical scale that combines severity of the clinical signs of hand eczema and the extent of skin involvement. The severity of 6 clinical signs of hand eczema is assessed on a scale from 0 to 3 in each of 5 areas of the hands. The extent of lesions in each area of the hands is evaluated based on a percentage involvement of surface area and is given a value between 0 and 4.
An extent and severity score for each of the 5 areas of the hands ranges from 0 to 72 points and is calculated as shown below:
- Erythema
- Induration/papulation
- Vesicles
- Fissuring
- Scaling
- Edema
Multiply
severity
by
extent
for each
clinical sign
| No skin changes | = 0 |
| Mild disease | = 1 |
| Moderate disease | = 2 |
| Severe disease | = 3 |
(Surface area
involvement)
| 0% | = 0 |
| 1% to 25% | = 1 |
| 26% to 50% | = 2 |
| 51% to 75% | = 3 |
| 76% to 100% | = 4 |
Severity multiplied by extent results in a score between 0 and 12 for each clinical sign. The scores for each of the 6 clinical signs are added, resulting in a score between 0 and 72 for each of the 5 areas of the hands.
(Excluding fingertips)
Total HECSI score is the sum of all 5 area scores and ranges from 0 to 360 points. Overall hand eczema extent and severity based on HECSI score is as follows:
Clear (0)
Almost clear (1-16)
Moderate (17-37)
Severe (38-116)
Very severe (≥117)
Dosage and
administration
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