Diagnostic criteria of atopic dermatitis by Hanifin and Rajka, UK Working Party, Japanese Dermatological Association, and Chinese guidelines for adolescent/adults

Hanifin and Rajka criteriaUK Working PartyJapanese Dermatological Association guidelinesChinese guidelines (adolescents/adults)

Major features:

  • Typical morphology and distribution: flexural lichenification or linearity in adults. Facial and extensor involvement in infants and children

  • Chronic or chronically relapsing dermatitis

  • Personal or family history of atopy (asthma, allergic rhinitis, atopic dermatitis)

Minor features:

  • Xerosis

  • Ichthyosis/palmar hyperlinearity/keratosis pilaris

  • Immediate (type 1) skin test reactivity

  • Elevated serum IgE

  • Early age of onset

  • Tendency towards cutaneous infections

  • Tendency towards nonspecific hand or foot dermatitis

  • Nipple eczema

  • Cheilitis

  • Recurrent conjunctivitis

  • Dennie-Morgan infraorbital fold

  • Keratoconus

  • Anterior subcapsular cataracts

  • Orbital darkening

  • Facial pallor/erythema

  • Pityriasis alba

  • Anterior neck folds

  • Itch when sweating

  • Intolerance to wool and lipid solvents

  • Food intolerance

  • Course influenced by environmental/emotional factors

  • White dermographism/delayed blanch

Major feature:

  • Itchy skin condition

Minor features:

  • History of asthma/hay fever

  • History of generalised dry skin

  • Onset of rash under the age of 2 years

  • Visible flexural dermatitis

Diagnosis: major plus three or more of the minor features

Major features:

  • Pruritus

  • Typical morphology and distribution

  • Chronic or chronically relapsing course

Diagnosis:

All above features must be present for more than 2 months in infancy and more than 6 months in childhood, adolescence, and adulthood.

Major feature:

  • Symmetrical eczema (dermatitis) for more than 6 months

Minor features:

  • Personal and/or family history of atopic diseases

  • Elevated total serum IgE level and/or positive allergen specific IgE and/or eosinophilia

Diagnosis: major plus one or more of the minor features