J Korean Med Assoc.  2014 Mar;57(3):212-217. 10.5124/jkma.2014.57.3.212.

Various diagnostic criteria for atopic dermatitis

• Lee SC

• KMID: 2064877
• DOI: http://doi.org/10.5124/jkma.2014.57.3.212

Abstract

Atopic dermatitis (AD) is one of the common forms of eczema in children, manifesting with chronic, relapsing attacks of skin eruptions with severe pruritus. Unfortunately, there is no consensus on the definition of AD or diagnostic criteria for AD. Therefore, various diagnostic criteria for AD have been proposed so far, which can be divided into a hospital- or community-setting. This paper reviews representative diagnostic criteria for AD among the proposed criteria. Hanfiin and Rajka's criteria is regarded as a 'gold standard. for AD diagnosis in a hospital-setting. AD diagnosis is made by combining the positive findings from skin symptoms, past history, and laboratory results. For epidemiological surveys in a community-setting, the International Study of Asthma and Allergies in Childhood (ISAAC), is commonly used worldwide as a questionnaire-based diagnostic criterion. For a community-setting, however, new diagnostic criteria with a good sensitivity and specificity need to be developed for epidemiological research as well as clinical consultations with patients.

Keyword

Atopic dermatitis; Diagnostic criteria; Epidemiological survey

MeSH Terms

Asthma
Child
Consensus
Dermatitis, Atopic*
Diagnosis
Eczema
Humans
Hypersensitivity
Pruritus
Referral and Consultation
Sensitivity and Specificity
Skin

Reference

1. Brenninkmeijer EE, Schram ME, Leeflang MM, Bos JD, Spuls PI. Diagnostic criteria for atopic dermatitis: a systematic review. Br J Dermatol. 2008; 158:754–765.

2. Williams H, Stewart A, von Mutius E, Cookson W, Anderson HR. International Study of Asthma and Allergies in Childhood (ISAAC) Phase One and Three Study Groups. Is eczema really on the increase worldwide? J Allergy Clin Immunol. 2008; 121:947–954.

3. Leung DY, Bieber T. Atopic dermatitis. Lancet. 2003; 361:151–160.

4. Hanifin JM, Rajka G. Diagnostic features of atopic dermatitis. Acta Derm Venereol Suppl (Stockh). 1980; 92:Suppl. 44–47.

5. Kang KF, Tian RM. Criteria for atopic dermatitis in a Chinese population. Acta Derm Venereol Suppl (Stockh). 1989; 144:26–27.

6. Schultz Larsen F, Hanifin JM. Secular change in the occurrence of atopic dermatitis. Acta Derm Venereol Suppl (Stockh). 1992; 176:7–12.

7. Williams HC, Burney PG, Pembroke AC, Hay RJ. The UK Working Party's diagnostic criteria for atopic dermatitis. III. Independent hospital validation. Br J Dermatol. 1994; 131:406–416.

8. Asher MI, Keil U, Anderson HR, Beasley R, Crane J, Martinez F, Mitchell EA, Pearce N, Sibbald B, Stewart AW, Strachan D, Weiland SK, Williams HC. International Study of Asthma and Allergies in Childhood (ISAAC): rationale and methods. Eur Respir J. 1995; 8:483–491.

9. Tagami H. Japanese Dermatology Association criteria for the diagnosis of atopic dermatitis. J Dermatol. 1995; 22:966–967.

10. Bos JD, Van Leent EJ, Sillevis Smitt JH. The millennium criteria for the diagnosis of atopic dermatitis. Exp Dermatol. 1998; 7:132–138.

11. Park YL, Kim HD, Kim KH, Kim MN, Kim JW, Ro YS, Park CW, Lee KH, Lee AY, Cho SH, Choi JH. Report from ADRG: A Study on the Diagnostic Criteria of Korean Atopic Dermatitis. Korean J Dermatol. 2006; 44:659–663.

12. Choi WJ, Ko JY, Kim JW, Lee KH, Park CW, Kim KH, Kim MN, Lee AY, Cho SH, Park YL, Choi JH, Seo SJ, Lee YW, Roh JY, Park YM, Kim DJ, Ro YS. Prevalence and risk factors for atopic dermatitis: a cross-sectional study of 6,453 Korean preschool children. Acta Derm Venereol. 2012; 92:467–471.

13. Czarnobilska E, Obtulowicz K, Dyga W, Spiewak R. A half of schoolchildren with 'ISAAC eczema' are ill with allergic contact dermatitis. J Eur Acad Dermatol Venereol. 2011; 25:1104–1107.