While patient and clinician assessment of skin disease severity are often aligned, it has been well documented that discordant assessments are also common. For instance, in a cross-sectional evaluation of patients with psoriatic disease that was treated in routine clinical practice in the US, 42% had a 1-level difference in severity scores (eg, mild vs moderate) and 9% had a 2-level difference in severity scores (eg, mild vs severe) between the Dermatology Life Quality Index (patient-reported outcome) and the Psoriasis Area Severity Index.1 In another cross-sectional study of patients with atopic dermatitis in the US, in approximately 20% of encounters, clinicians rated severity higher than patients, and in 10% of encounters, patients reported severity higher than clinicians.2 A study of outpatients treated in Italy found that agreement between clinician and patient severity was low (κ = 0.25).3