dermatology paediatrics

POEM — Patient-Oriented Eczema Measure

7-item patient/parent-reported atopic eczema symptom score (Charman 2004). Each item 0–4 (days in past week). Total 0–28. Recommended core outcome by HOME initiative.

Q1. Itchy skin — number of days in past week*

Q2. Disturbed sleep because of eczema — number of days in past week*

Q3. Bleeding skin — number of days in past week*

Q4. Skin weeping or oozing clear fluid — number of days in past week*

Q5. Cracked skin — number of days in past week*

Q6. Flaking skin — number of days in past week*

Q7. Dry or rough skin — number of days in past week*

Score interpretation

Clear / almost clear 0–2

→ Maintain emollient regimen. Step-down topical therapy if used regularly.

Mild eczema 3–7

→ Emollients ≥4×/day; mild topical corticosteroid for active patches. Trigger avoidance.

Moderate eczema 8–16

→ Potent topical corticosteroid short courses + emollients. Tacrolimus / pimecrolimus for face / folds. Treat infection if oozing / crusting (S. aureus / HSV). Consider phototherapy.

Severe eczema 17–24

→ Specialist dermatology referral. Systemic immunomodulator (ciclosporin, methotrexate, dupilumab, baricitinib per NICE TAs).

Very severe eczema 25–28

→ Urgent dermatology. Systemic therapy / biologic; admission for wet wraps; treat eczema herpeticum / bacterial superinfection aggressively.

Interpretation bands for the POEM. Apply clinical judgement and local guidance.

References

Curated clinical cross-links plus same-class fallbacks.

Drugs

Pathways

Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.

Score interpretation

References

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