Criteria

Hanifin and Rajka criteria[68][69]

The diagnosis of eczema using the Hanifin and Rajka criteria requires that patients have at least 3 of the 4 major criteria and 3 of the 23 minor criteria.

Major criteria:

  • Pruritus

  • Dermatitis affecting flexural surfaces in adults and the face and extensors in infants

  • Chronic or relapsing dermatitis

  • Personal or family history of cutaneous or respiratory atopy.

Minor criteria can be divided into 4 categories.

  • Facial features: facial pallor, facial erythema, hypopigmented patches, infra-orbital darkening, infra-orbital folds (Dennie-Morgan folds), cheilitis, recurrent conjunctivitis, anterior neck folds.

  • Triggers: foods, emotional factors, environmental factors, skin irritants.

  • Complications: susceptibility to cutaneous infections, impaired cell-mediated immunity, immediate skin-test reactivity, elevated IgE, keratoconus, anterior subcapsular cataracts.

  • Other: early age of onset, dry skin, ichthyosis, hyperlinear palms, keratosis pilaris, hand and foot dermatitis, nipple eczema, white dermatographism, perifollicular accentuation.

The Hanifin and Rajka criteria are the most commonly used eczema diagnostic criteria in randomised controlled trials internationally.[70]

Danish Allergy Research Center criteria[71]

Diagnosis of eczema based on the Danish Allergy Research Center criteria requires the presence of the following.

1. Personal history of itching within the last 3 months, or visible evidence of itching or scratching at the time of examination.

2. Eczema in at least 2 of the following 4 regions:

  • Face or neck

  • Trunk

  • Flexor or extensor aspects of arms or legs.

OR a history of eczema in at least 2 of the following 5 regions in the last 3 months:

  • Antecubital or popliteal fossae

  • Wrists or ankles

  • Face or neck

  • Hands, arms, or legs

  • Body.

3. Continuing itchy eczema during the past 6 weeks.

United Kingdom Working Party diagnostic criteria[72][73][74]

Patients must have a history of itchy skin plus at least 3 of the following:

  • History of a flexural involvement (antecubital or popliteal fossae, front of ankles, wrists, or neck)

  • Visible flexural dermatitis

  • Personal history of asthma or hay fever (or history of atopic disease in parents or siblings if the patient is younger than 4 years of age)

  • History of a generally dry skin in the last year

  • Onset under the age of 2.

Use of this content is subject to our disclaimer