1. CDASI Training Tool Victoria P. Werth, M.D. University of Pennsylvania
Copyright © 2011 University of Pennsylvania

2. Purpose Prerequisite for realistically powered trials
Need a tool to measure improvement of disease for clinical use and for dermatology trials
Need a precise and reliable outcome measure for Dermatomyositis (DM)
Reliable, consistent, (high interrater and intrarater reliability)
Validity/sensitivity
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3. Design Issues Quick to use High inter-rater & intra-rater reliability
Easy to use
What this means
Describe a few clear symptoms:
e.g. erythema to reflect activity,
dyspigmentation to reflect damage
No attempt to assess percentage clinically
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4. CDASI use Rate the worst score for each body area listed in the CDASI
If some areas on the arm are pink and some are red, then rate the arm as red.
One area on the arm may be red and a different area may be scaly. Rate the worst area for each attribute.
If there are papules (elevations in skin, not just flat macules) in the Gottron‘s area on the hands, then the score for the worst area (pink, red, or dark red) is doubled.
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5. (1) CDASI Anatomical location: Upper Back & Shoulders Posterior Neck
ACTIVITY
Erythema:
Neither dark or purple, nor pink or faint
Red (2)
Scale and Ulceration:
Absent (0)
DAMAGE
Poikiloderma:
Present (1)
Calcinosis:
Absent (0)
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6. (2) CDASI Anatomical location: Gottron‘s - Not on Hands ACTIVITY
Erythema:
Pink; faint erythema (1)
Scale:
Scale (1)
Ulceration:
Absent (0)
DAMAGE
Poikiloderma, Calcinosis:
Absent (0)
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7. (3) CDASI Anatomical location:
Scalp, Malar, Periorbital, V-area of neck
ACTIVITY
Erythema:
Dark red; purple (3)
Scale or Ulceration:
Absent (0)
DAMAGE
Poikiloderma:
Present on V-area (1)
Calcinosis:
Absent (0)
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8. (4) CDASI Anatomical location: Periungual ACTIVITY Periungual Changes:
Visible telangectasias (2)
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9. (5) CDASI Anatomical location: Arm
All Secondary to LIVEDO (non-specific)
ACTIVITY
Erythema:
Absent (0)
Scale:
Ulceration:
DAMAGE
Poikiloderma:
Absent (0)
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10. (6) CDASI Anatomical location: Scalp ACTIVITY Erythema: Pink (1)
Scale or Ulceration:
Absent (0)
Alopecia:
Recent hair loss (last 30 days): Absent or Present?
DAMAGE
Poikiloderma, Calcinosis:
Absent (0)
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11. (7) CDASI Anatomical location: Abdomen ACTIVITY Erythema:
Dark red; purple (3)
Scale or Ulceration:
Absent (0)
DAMAGE
Poikiloderma:
Present (1)
Calcinosis:
Absent (0)
Copyright © 2011 University of Pennsylvania

12. (8) CDASI Anatomical location: Periorbital ACTIVITY DAMAGE Erythema:
Not red or dark-red
Pink (1)
Scale or Ulceration:
Absent (0)
DAMAGE
Poikiloderma, Calcinosis:
Absent (0)
Copyright © 2011 University of Pennsylvania

13. (9) CDASI Anatomical location: Gottron‘s – Hands
Dorsum of Hands (not over joints)
ACTIVITY
Pink; faint erythema (1)
If papules present, then double score
Ulceration absent (0)
DAMAGE
Absent (0)
Copyright © 2011 University of Pennsylvania

14. References for CDASI Validation Studies
Klein RQ, Bangert CC, Costner M, Connolly MK, Dugan, Tanikawa EA, Okawa J, Rose M, Fakharzadeh SS, Fiorentino D, Lee LA, Sontheimer RD, Taylor L, Troxel AB, Werth VP. The CDASI, DSSI, & CAT: Comparison of reliability and validity in the development of an outcome instrument for cutaneous dermatomyositis. Br J Dermatol 159: , 2008.
Yassaee M, Fiorentino D, Taylor L, Okawa J, Werth VP. Modification of the Cutaneous Dermatomyositis Disease Area and Severity Index, an outcome measure instrument. Br J Dermatol 162: , 2010.
Copyright © 2011 University of Pennsylvania

15. References for CDASI Validation Studies
Chock M, Goreshi R, Werth VP, Fiorentino D. Quantitative assessment of disease severity in dermatomyositis. J Invest Dermatol (abstr), 130 (Suppl 1): S50, 2010.
Goreshi R, Okawa J, Rose M, Taylor L, Lee L, Hansen C, Bangert C, Connolly K, Davis M, Callen J, Fett N, Fakharzadeh S, Clarke J, Werth VP. Evaluation of reliability, validity, and responsiveness of the CDASI, CAT-BM, and the CAT-MM. J Invest Dermatol, 2012; 132(4):
Copyright © 2011 University of Pennsylvania