Atopic dermatitis diagnostic study of choice: Difference between revisions
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== Overview == | == Overview == | ||
Due to the variable morphology, distribution of skin lesions and intermittent clinical features, it is very challenging to define the diagnosis of atopic dermatitis. Atopic dermatitis is primarily diagnosed based on the clinical presentation. Currently, the most used criteria worldwide is published by United Kingdom working group and is based upon history, morphology and distribution of eczematous lesions, and clinical features of atopic dermatitis. | Due to the variable [[morphology]], distribution of skin [[lesions]] and intermittent clinical features, it is very challenging to define the diagnosis of atopic dermatitis. Atopic dermatitis is primarily diagnosed based on the [[clinical]] presentation. Currently, the most used [[Criterion|criteria]] worldwide is published by United Kingdom working group and is based upon history, morphology and distribution of [[Eczema|eczematous]] [[lesions]], and clinical features of atopic dermatitis. | ||
== Diagnostic Study of Choice == | == Diagnostic Study of Choice == | ||
* There is no single diagnostic study of choice for routinely diagnosis of atopic dermatitis, but in selected patients,to rule out other skin conditions, histology examination of a [[skin biopsy]] and other laboratory tests (eg, [[Immunoglobulin E|serum immunoglobulin E]], [[KOH test|potassium hydroxide preparation]], patch testing, [[genetic testing]]) | * There is no single diagnostic study of choice for routinely diagnosis of atopic dermatitis, but in selected patients,to rule out other skin conditions, histology examination of a [[skin biopsy]] and other laboratory tests (eg, [[Immunoglobulin E|serum immunoglobulin E]], [[KOH test|potassium hydroxide preparation]], patch testing, [[genetic testing]]) may be considered.<ref name="pmid242904312">{{cite journal |vauthors=Eichenfield LF, Tom WL, Chamlin SL, Feldman SR, Hanifin JM, Simpson EL, Berger TG, Bergman JN, Cohen DE, Cooper KD, Cordoro KM, Davis DM, Krol A, Margolis DJ, Paller AS, Schwarzenberger K, Silverman RA, Williams HC, Elmets CA, Block J, Harrod CG, Smith Begolka W, Sidbury R |title=Guidelines of care for the management of atopic dermatitis: section 1. Diagnosis and assessment of atopic dermatitis |journal=J. Am. Acad. Dermatol. |volume=70 |issue=2 |pages=338–51 |date=February 2014 |pmid=24290431 |pmc=4410183 |doi=10.1016/j.jaad.2013.10.010 |url=}}</ref> | ||
=== Diagnostic Criteria: === | === Diagnostic Criteria: === | ||
* Atopic dermatitis is primarily diagnosed based on clinical presentation. There are several established criteria for the diagnosis of atopic dermatitis, the earliest and most | * Atopic dermatitis is primarily diagnosed based on clinical presentation. There are several established criteria for the diagnosis of atopic dermatitis, the earliest and most accepted diagnostic criteria being the 1980 Hanifin and Rajka criteria was used previously.<ref name="pmid16086748">{{cite journal |vauthors=Jøhnke H, Vach W, Norberg LA, Bindslev-Jensen C, Høst A, Andersen KE |title=A comparison between criteria for diagnosing atopic eczema in infants |journal=Br. J. Dermatol. |volume=153 |issue=2 |pages=352–8 |date=August 2005 |pmid=16086748 |doi=10.1111/j.1365-2133.2005.06491.x |url=}}</ref><ref>{{cite journal |last1= Hanifin |first1=Jon M. |last2= Rajka |first2=Georg |date= |title=Diagnostic Features of Atopic Dermatitis|url=https://www.medicaljournals.se/acta/content/abstract/10.2340/00015555924447 |journal= Acta Derm Venereol Suppl (Stockh) |volume=60 |issue=92 |pages=44-47 |doi=10.2340/00015555924447 |access-date= }}</ref> | ||
* Currently, the most used criteria worldwide is published by United Kingdom working group and is based upon history, morphology and distribution of eczematous lesions, and clinical features of atopic dermatitis.<ref name="pmid24290431">{{cite journal |vauthors=Eichenfield LF, Tom WL, Chamlin SL, Feldman SR, Hanifin JM, Simpson EL, Berger TG, Bergman JN, Cohen DE, Cooper KD, Cordoro KM, Davis DM, Krol A, Margolis DJ, Paller AS, Schwarzenberger K, Silverman RA, Williams HC, Elmets CA, Block J, Harrod CG, Smith Begolka W, Sidbury R |title=Guidelines of care for the management of atopic dermatitis: section 1. Diagnosis and assessment of atopic dermatitis |journal=J. Am. Acad. Dermatol. |volume=70 |issue=2 |pages=338–51 |date=February 2014 |pmid=24290431 |pmc=4410183 |doi=10.1016/j.jaad.2013.10.010 |url=}}</ref> | * Currently, the most used criteria worldwide is published by United Kingdom working group and is based upon history, morphology and distribution of eczematous lesions, and clinical features of atopic dermatitis.<ref name="pmid24290431">{{cite journal |vauthors=Eichenfield LF, Tom WL, Chamlin SL, Feldman SR, Hanifin JM, Simpson EL, Berger TG, Bergman JN, Cohen DE, Cooper KD, Cordoro KM, Davis DM, Krol A, Margolis DJ, Paller AS, Schwarzenberger K, Silverman RA, Williams HC, Elmets CA, Block J, Harrod CG, Smith Begolka W, Sidbury R |title=Guidelines of care for the management of atopic dermatitis: section 1. Diagnosis and assessment of atopic dermatitis |journal=J. Am. Acad. Dermatol. |volume=70 |issue=2 |pages=338–51 |date=February 2014 |pmid=24290431 |pmc=4410183 |doi=10.1016/j.jaad.2013.10.010 |url=}}</ref> | ||
* United Kingdom working group criteria includes one mandatory and 3 or more from the 5 major criteria.<ref name="pmid7918017">{{cite journal |vauthors=Williams HC, Burney PG, Pembroke AC, Hay RJ |title=The U.K. Working Party's Diagnostic Criteria for Atopic Dermatitis. III. Independent hospital validation |journal=Br. J. Dermatol. |volume=131 |issue=3 |pages=406–16 |date=September 1994 |pmid=7918017 |doi= |url=}}</ref> | * United Kingdom working group criteria includes one mandatory and 3 or more from the 5 major criteria.<ref name="pmid7918017">{{cite journal |vauthors=Williams HC, Burney PG, Pembroke AC, Hay RJ |title=The U.K. Working Party's Diagnostic Criteria for Atopic Dermatitis. III. Independent hospital validation |journal=Br. J. Dermatol. |volume=131 |issue=3 |pages=406–16 |date=September 1994 |pmid=7918017 |doi= |url=}}</ref> | ||
{| class="wikitable" | {| class="wikitable" | ||
!Atopic dermatitis diagnostic criteria | ! colspan="3" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Atopic dermatitis diagnostic criteria | ||
|- | |- | ||
| | | | ||
* Mandatory criteria:<ref name="pmid7918017" /> | * Mandatory criteria:<ref name="pmid7918017" /> | ||
** Evidence of [[pruritus]] or report of scratching or rubbing by the parent | ** Evidence of [[pruritus]] or report of scratching or rubbing by the parent | ||
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|Adapted from U.K. Working Party's Diagnostic Criteria | |Adapted from U.K. Working Party's Diagnostic Criteria | ||
|} | |} | ||
* The | * The basis for making decisions about treatment depends upon:<ref name="pmid10730763">{{cite journal |vauthors=Emerson RM, Charman CR, Williams HC |title=The Nottingham Eczema Severity Score: preliminary refinement of the Rajka and Langeland grading |journal=Br. J. Dermatol. |volume=142 |issue=2 |pages=288–97 |date=February 2000 |pmid=10730763 |doi= |url=}}</ref> | ||
** Presence or absence of [[Sleep disturbances|sleep disturbance]] | ** Presence or absence of [[Sleep disturbances|sleep disturbance]] | ||
** Number and location of involved sites | ** Number and location of involved sites | ||
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Shalinder Singh, M.B.B.S.[2]
Overview
Due to the variable morphology, distribution of skin lesions and intermittent clinical features, it is very challenging to define the diagnosis of atopic dermatitis. Atopic dermatitis is primarily diagnosed based on the clinical presentation. Currently, the most used criteria worldwide is published by United Kingdom working group and is based upon history, morphology and distribution of eczematous lesions, and clinical features of atopic dermatitis.
Diagnostic Study of Choice
- There is no single diagnostic study of choice for routinely diagnosis of atopic dermatitis, but in selected patients,to rule out other skin conditions, histology examination of a skin biopsy and other laboratory tests (eg, serum immunoglobulin E, potassium hydroxide preparation, patch testing, genetic testing) may be considered.[1]
Diagnostic Criteria:
- Atopic dermatitis is primarily diagnosed based on clinical presentation. There are several established criteria for the diagnosis of atopic dermatitis, the earliest and most accepted diagnostic criteria being the 1980 Hanifin and Rajka criteria was used previously.[2][3]
- Currently, the most used criteria worldwide is published by United Kingdom working group and is based upon history, morphology and distribution of eczematous lesions, and clinical features of atopic dermatitis.[4]
- United Kingdom working group criteria includes one mandatory and 3 or more from the 5 major criteria.[5]
| Atopic dermatitis diagnostic criteria | ||
|---|---|---|
| ||
| Adapted from U.K. Working Party's Diagnostic Criteria | ||
- The basis for making decisions about treatment depends upon:[6]
- Presence or absence of sleep disturbance
- Number and location of involved sites
- Clinical course of the disease
References
- ↑ Eichenfield LF, Tom WL, Chamlin SL, Feldman SR, Hanifin JM, Simpson EL, Berger TG, Bergman JN, Cohen DE, Cooper KD, Cordoro KM, Davis DM, Krol A, Margolis DJ, Paller AS, Schwarzenberger K, Silverman RA, Williams HC, Elmets CA, Block J, Harrod CG, Smith Begolka W, Sidbury R (February 2014). "Guidelines of care for the management of atopic dermatitis: section 1. Diagnosis and assessment of atopic dermatitis". J. Am. Acad. Dermatol. 70 (2): 338–51. doi:10.1016/j.jaad.2013.10.010. PMC 4410183. PMID 24290431.
- ↑ Jøhnke H, Vach W, Norberg LA, Bindslev-Jensen C, Høst A, Andersen KE (August 2005). "A comparison between criteria for diagnosing atopic eczema in infants". Br. J. Dermatol. 153 (2): 352–8. doi:10.1111/j.1365-2133.2005.06491.x. PMID 16086748.
- ↑ Hanifin, Jon M.; Rajka, Georg. "Diagnostic Features of Atopic Dermatitis". Acta Derm Venereol Suppl (Stockh). 60 (92): 44–47. doi:10.2340/00015555924447.
- ↑ Eichenfield LF, Tom WL, Chamlin SL, Feldman SR, Hanifin JM, Simpson EL, Berger TG, Bergman JN, Cohen DE, Cooper KD, Cordoro KM, Davis DM, Krol A, Margolis DJ, Paller AS, Schwarzenberger K, Silverman RA, Williams HC, Elmets CA, Block J, Harrod CG, Smith Begolka W, Sidbury R (February 2014). "Guidelines of care for the management of atopic dermatitis: section 1. Diagnosis and assessment of atopic dermatitis". J. Am. Acad. Dermatol. 70 (2): 338–51. doi:10.1016/j.jaad.2013.10.010. PMC 4410183. PMID 24290431.
- ↑ 5.0 5.1 5.2 Williams HC, Burney PG, Pembroke AC, Hay RJ (September 1994). "The U.K. Working Party's Diagnostic Criteria for Atopic Dermatitis. III. Independent hospital validation". Br. J. Dermatol. 131 (3): 406–16. PMID 7918017.
- ↑ Emerson RM, Charman CR, Williams HC (February 2000). "The Nottingham Eczema Severity Score: preliminary refinement of the Rajka and Langeland grading". Br. J. Dermatol. 142 (2): 288–97. PMID 10730763.