Hanifin and Rajka Diagnostic Criteria for Atopic Dermatitis (AD)Major criteria: Must have three or more of:1. Pruritus2. Typical morphology and distribution Flexural lichenification or linearity in adults Facial and extensor involvement in infants and children3. Chronic or chronically-relapsing dermatitis4. Personal or family history of atopy (asthma, allergic rhinitis, atopic dermatitis)Minor criteria: Should have three or more of:1. Xerosis2. Ichthyosis, palmar hyperlinearity, or keratosis pilaris3. Immediate (type 1) skin-test reactivity4. Raised serum IgE5. Early age of onset6. Tendency toward cutaneous infections (especially S aureus and herpes simplex) or impaired cell-mediated immunity7. Tendency toward non-specific hand or foot dermatitis8. Nipple eczema9. Cheilitis10. Recurrent conjunctivitis11. Dennie-Morgan infraorbital fold12. Keratoconus13. Anterior subcapsular cataracts14. Orbital darkening15. Facial pallor or facial erythema16. Pityriasis alba17. Anterior neck folds18. Itch when sweating19. Intolerance to wool and lipid solvents20. Perifollicular accentuation21. Food intolerance22. Course influenced by environmental or emotional factors23. White dermographism or delayed blanchSuggested Universal Criteria for Atopic Dermatitis (AD) by American Academy of DermatologyA. Essential features; must be present and, if complete, are sufficient for diagnosis:1. Pruritus2. Eczematous changes that are acute, subacute, or chronic:a. Typical and age-specific patterns(i) Facial, neck, and extensor involvement in infants and children(ii) Current or prior flexural lesions in adults/any age(iii) Sparing of groin and axillary regionsb. Chronic or relapsing courseB. Important features that are seen in most cases, adding support to the diagnosis:1. Early age at onset2. Atopy (IgE reactivity)3. XerosisC. Associated features: Clinical associations; help in suggesting the diagnosis of AD but are too nonspecific to be used for defining or detecting AD for research and epidemiologic studies1. Keratosis pilaris/Ichthyosis/Palmar hyperlinearity2. Atypical vascular responses3. Perifollicular accentuation/Lichenification/Prurigo4. Ocular/periorbital changes5. Perioral/periauricular lesionsD. Exclusions: Firm diagnosis of AD depends on excluding conditions such as scabies, allergic contact dermatitis, seborrheic dermatitis, cutaneous lymphoma, ichthyoses, psoriasis, and other primary disease entities.References:

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