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New Diagnostic Criteria for Atopic Dermatitis in Children
New criteria for children yielded higher sensitivity for the diagnosis of atopic dermatitis (AD), particularly for mild and moderate AD, a new study found. Researchers screened atopic features and analyzed their correlation with AD using data from a previous study. A new set of diagnostic criteria for children in China were proposed and validated in 1,031 children in outpatient clinics, and 538 children in a birth cohort survey. Clinical diagnosis and atopic feature evaluation was performed face-to-face by dermatologists. Among the findings:
- The new diagnostic criteria for children were based on pruritus; “typical morphology and distribution” or “atypical morphology and distribution with xerosis”; and a chronic or chronically relapsing course.
- The sensitivity of the new diagnostic criteria was significantly higher in the epidemiological survey and the clinical setting.
- The new criteria demonstrated similar sensitivity and specificity in the birth cohort.
Cheng R, et al. Development and validation of new diagnostic criteria for atopic dermatitis in children of China. [Published online ahead of print September 30, 2019]. J Eur Acad Dermatol Venereol. doi: 10.1111/jdv.15979.
Atopic dermatitis is one of the conditions most frequently seen by dermatologists and usually one of the easiest to diagnose quickly on skin examination and with a bit of history. But there are "diagnostic criteria" that are rather complicated and require meeting a set of parameters and acquiring enough "points" before the diagnosis is made. While these may be important in research settings, they are rarely used clinically. This article reinforces the concept that a few simple items, including itching, recurrence, and a typical skin distribution of eczematous lesions are all one needs to accurately make a diagnosis. — Joseph Fowler, Jr., MD, Clinical Professor of Dermatology, University of Louisville, KY