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Scoring Mastocytosis (SCORMA) Index

Scoring Mastocytosis (SCORMA) Index
Extent of skin involvement (A)
Percentage of body surface area with mastocytosis lesions, traced on a body diagram.
%
Pigmentation / erythema of a representative lesion
Rate the most affected representative lesion on a 0-3 scale.
Vesiculation of a representative lesion
Elevation (swelling) of a representative lesion
Darier's sign (whealing on rubbing) of a representative lesion
Daily inconvenience from provoking factors
Visual analogue scale over the preceding 3 weeks, 0 = none, 10 = worst imaginable.
/10
Flushing
/10
Diarrhoea
/10
Pruritus
/10
Localized bone pain
/10
Complete the fields above to see the result.

When to use

  • Quantifying the severity of cutaneous mastocytosis (urticaria pigmentosa, diffuse cutaneous mastocytosis, mastocytoma) at baseline and on treatment.
  • Tracking response to therapy over serial visits using a reproducible, semi-quantitative index.

Formula

SCORMA index = A/5 + 5B + 2C/5, where A = % body surface area involved (0-100); B = sum of 4 lesional-activity items (pigmentation/erythema, vesiculation, elevation, Darier's sign), each rated 0-3 (raw range 0-12); C = sum of 5 subjective symptoms (provoking-factor inconvenience, flushing, diarrhoea, pruritus, localized bone pain) each on a 0-10 VAS over the preceding 3 weeks (raw range 0-50). Lesional activity (B) is weighted 3-fold relative to extent and subjective symptoms, by analogy with the SCORAD index for atopic dermatitis.

Pearls and pitfalls

  • No validated severity cutoffs exist for the SCORMA index; the bands used here (low <20, moderate 20-40, high >40) are a descriptive convenience, not part of the original validated index, and are not intended to guide treatment decisions.
  • Assess the same representative lesion at each visit to keep the intensity component (B) comparable over time.

References

  1. Heide R, Middelkamp Hup MA, Mulder PGH, Oranje AP. Clinical scoring of cutaneous mastocytosis. Acta Derm Venereol. 2001;81(4):273-6.
  2. Heide R, van Doorn K, Mulder PGH, et al. Serum tryptase and SCORMA (SCORing MAstocytosis) Index as disease severity parameters in childhood and adult cutaneous mastocytosis. Clin Exp Dermatol. 2009;34(4):462-8.