Diagnostic Tool

1 / DIAGNOSTIC CRITERIA

Essential features that must be present

• Pruritus
• Eczema (acute, subacute, chronic) with

- Chronic or relapsing history

- Typical morphology and age-specific patterns

Important features seen in most cases that add support to the diagnosis

• Early age of onset
• Atopy

- Personal or family history
- IgE reactivity

• Xerosis

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2 / ASSOCIATED CONDITIONS

The presence of the following conditions supports the likelihood of a diagnosis of atopic der- matitis, but they are not necessary or sufficient for diagnosis:

• Morgan folds

• Hyperlinearity of the palms and soles

• Lichenification

• Keratosis pilaris

• Pityriasis alba

• Ichthyosis vulgaris

Other potential associated conditions:

• Sensitization to common food or inhalant allergens (particularly in young children)
• Tendency to skin infections
• Atypical vascular response (pallor; white dermographism, delayed blanch response)
• Ocular or periorbital changes
• Perifollicular accentuation
• Prurigo lesions

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3 / DIFFERENTIAL DIAGNOSIS

Rule out the following:

• Scabies

• Contact dermatitis (irritant or allergic)

• Seborrheic dermatitis

• Psoriasis

• Tinea corporis
• Photosensitivity dermatoses
• Nutritional deficiencies
• Nummular dermatitis
• Ichthyoses
• Immune deficiency diseases
• Cutaneous T-cell lymphoma
• Erythroderma of other causes

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4 / AFTER A POSITIVE DIAGNOSIS

Follow treatment guidelines.
Provide education and implement psychosocial interventions.
At subsequent visits always consider:

• Itch

• Effect on sleep

• Effect on daily activities, caregivers

• Depression, anxiety, and ADHD

• Persistence of disease

If atopic dermatitis treatment fails consider inadequate adherence, alternate
diagnoses, and/or the need for dermatologic consultation.