Diagnostic Criteria for Atopic Dermatitis in Thai Children
Wanee Wisuthsarewong MD*, Suchitra Viravan MD*
Affiliation : * Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University
Atopic dermatitis (AD) is a common skin disease in Thai children. There is no clinical or laboratory
gold standard for the diagnosis. It is generally based on the guideline proposed by Hanifin and Rajka. Many
studies have shown that some criteria are probably not all that significant in making the diagnosis. This study
was designed to evaluate the frequency and diagnostic significance of clinical features of AD in Thai children.
The authors studied 108 patients with AD and 103 controls including patients with other skin diseases. The
AD group consisted of 60 girls and 48 boys. The mean age was 60.3 + 36.1 months. All previously proposed
features were evaluated and the difference in frequency was tested with the chi-square test.
History of pruritus, rash on typical distribution, chronically relapsing course, duration more than
6 months, personal or family history of atopy, age of onset before 2 years, recurrent conjunctivitis, itch when
sweating, intolerance to rough textile, food and milk intolerance, history of dry skin, seasonal variation, visible
dermatitis, dermatitis of a typical distribution, xerosis, ichthyosis vulgaris, foot dermatitis, Dennie-Morgan
infraorbital fold, orbital darkening, periorbital dermatitis, pityriasis alba, peri-auricular dermatitis, anterior
neck fold, truncal dermatitis, perifollicular accentuation, white dermographism and diffuse scaling of scalp
were all significantly more frequent in AD (p < 0.05).
A minimum set of diagnostic criteria for AD was derived by using multiple stepwise logistic regression
technique. It consisted of history of itchy rash, history of flexural dermatitis, chronicity more than 6 months,
and visible xerosis, periorbital dermatitis and perifollicular accentuation.
Keywords : Atopic dermatitis, Diagnostic criteria, Diagnosis
