What Is Eczema?

Eczema Series

What Is Eczema?

Supported by independent educational grants from Sanofi Genzyme and Regeneron Pharmaceuticals, Pfizer, and Incyte.
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Authors:
Vivian Shi, MD Kristin Blake, MOM, LAc
Editors:
Raja Sivamani, MD MS AP
Summary

What Is Atopic Dermatitis?

One of the earliest and most used diagnostic criteria for AD is the Hanifin and Rjaka criteria:[16]

Major criteria (must have 3)

  1. Pruritus
  2. Dermatitis affecting flexural surfaces in adults or face and extensor surfaces in infants
  3. Chronic or relapsing dermatitis
  4. Personal or family history of skin or respiratory allergy

Minor criteria (must have 3)

  1. Facial features: pallor, erythema, hypopigmented patches, infraorbital darkening, cheilitis, infraorbital fold (Dennie Morgan lines), recurrent conjunctivitis, anterior neck folds
  2. Triggers: emotional, environmental, food, skin irritants
  3. Complications: susceptibility to skin infections, impaired cell-mediated immunity, predisposition to keratoconus and anterior subscapular cataracts, immediate skin reactivity
  4. Others: early age of onset, dry skin, ichthyosis, hyperlinear palms, keratosis pilaris, hand and foot dermatitis, nipple eczema, white dermatographism, perifollicular accentuation

Additional grading criteria for AD clinical severity and symptom severity include

  • SCORAD (Scoring atopic dermatitis)[17]
  • EASI (Eczema area and severity index)[18]
  • PO-SCORAD (Patient-oriented SCORAD)[19]
  • POEM (Patient-oriented eczema measure)[20]
  • Itch Severity Scale[21]

 

In 2004, the American Academy of Dermatology came out with their own consensus guidelines for the diagnosis of AD.[22] These guidelines are overall comparable.