THE UK WORKING PARTY DIAGNOSTIC-CRITERIA FOR ATOPIC-DERMATITIS .1. DERIVATION OF A MINIMUM SET OF DISCRIMINATORS FOR ATOPIC-DERMATITIS

A working party of 13 dermatologists, two family practitioners and a p aediatrician was assembled, with the aim of developing a minimum list of reliable discriminators for atopic dermatitis. Each physician was a sked to select 10 consecutive new cases of unequivocal mild to moderat e atopic dermatitis and 10 controls with other inflammatory dermatoses . Each subject was examined by two independent observers, who were bli nd to the clinical diagnosis and study aim, with regard to 31 clinical ly useful diagnostic features for atopic dermatitis. Two hundred and t wenty-four patients were studied (120 cases and 102 controls). Using t he key physician's clinical diagnosis as a gold standard, the sensitiv ity and specificity of each of the 31 diagnostic criteria were tested. Using multiple logistic regression techniques, a minimum set of diagno stic criteria for atopic dermatitis was derived. These were: history o f flexural involvement, history of a dry skin, onset under the age of 2, personal history of asthma, history of a pruritic skin condition, a nd visible flexural dermatitis. Adjustment for age, sex, region, socia l class and ethnic group did not alter the choice of final criteria. T he discriminatory value of these criteria was also satisfactory when t ested against a further sample of 150 patients drawn from the communit y, who did not have skin disease.