Prominent pruritic periumbilical papules: A diagnostic sign in pediatric atopic dermatitis

Establishment of diagnostic criteria for atopic dermatitis has been a subje ct of controversy and frequent reevaluation, The diagnostic criteria of Han ifin and Rajka are those most frequently cited. In order to fit the diagnos is, a patient must demonstrate three major criteria plus four or more minor criteria. Although individually the minor criteria are not diagnostic, the ir presence suggests the possibility of atopic dermatitis. Recently we eval uated several children who developed prominent periumbilical papules as a m ajor component of their atopic dermatitis. This finding, while not present in all children with atopic dermatitis, can provide a specific clue to diag nosis and should be considered as a new minor criterion for atopic dermatit is in children.