Validation of the UK diagnostic criteria for atopic dermatitis in paediatrics

1 Klinika Dermatologii Wojskowego Instytutu Medycznego w Warszawie. Kierownik Kliniki: prof. dr hab. n. med. Stanisław Zabielski
2 Oddział Dermatologii Dziecięcej Szpitala św. Łazarza w Warszawie. Ordynator Oddziału: dr n. med. Danuta Rosińska-Borkowska
Correspondence to: Klinika Dermatologii WIM, ul. Szaserów 128, 00-909 Warszawa, tel.: 022 681 62 29
Source of financing: Department own sources

Pediatr Med rodz Vol 5 Numer 3, p. 219-225

The number of various diagnostic criteria for atopic eczema that have been carried out world-wide shows how many difficulties and doubts this diagnose still causes. In 1994 one of those criteria were presented by the UK working party’s (Williams et al.). The aim of his study was to examine the validity of the UK diagnostic criteria for atopic dermatitis in children and to compare the results with those of Hanifin and Rajka. One hundred and sixty six children from paediatric out-patient clinic (67 boys and 99 girls) aged 4-15 lat (mean age 10.3) were examined. All of them beside the skin changes had pruritus. They underwent thorough clinical examination and were assessed according to Hanifin and Rajka criteria. The results were then subjected to statistical analysis. Atopic eczema was diagnosed in 108 children, remaining 58 infants suffered from scabies, seborrhoic dermatitis, irritant reactions, psoriasis vulgaris, acne vulgaris and urticaria. All of the examined children had a history of dry skin in the last year. History of involvement of typical skin areas, onset under the age of 2, visible eczema of typical localization and a personal history of asthma or hay fever were noted in 96,3% (104/108), 71.3% (77/108), 67.6% (73/108) and 64.3% (70/108) respectively. All of those features were observed more frequently in comparison with the group of non-atopic children and that fact was statistically significant (p<0.001). In 3/108 examined children the results turned false negative and in 2/58 – false positive. The Williams criteria showed sensitivity and specificity of 97.2% and 96.6% respectively. Conclusions: 1. The UK diagnostic criteria for atopic dermatitis are very useful in paediatrician everyday practice, especially in children over 3 years old. 2. Both features general dry skin and history of skin involvement in typical localization are the most useful in diagnosing atopic eczema in children. 3. In complicated and doubtful cases the age limit of the early onset below 2 might be stretched up to 5 which improves overall diagnostic efficiency.

Keywords: atopic dermatitis, children, criteria of Williams et al., diagnosis, itching