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Assessment of the American Academy of Dermatology diagnostic criteria for pediatric atopic dermatitis and modification into a checkbox form: A cross-sectional study |
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| Authors: | Jeremy Udkoff MD MA MAS Jenna Borok MD MAS Florin Vaida PhD Bin Tang PhD Catalina Matiz MD Jusleen Ahluwalia MD Emma Russell BA Lawrence Eichenfield MD |
| Institution: | 1. Department of Dermatology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA;2. Division of Dermatology, Albert Einstein College of Medicine, Bronx, New York, USA;3. Division of Biostatistics, School of Public Health, University of California San Diego, La Jolla, California, USA;4. Department of Psychiatry, University of California San Diego, La Jolla, California, USA;5. Southern California Permanente Medical Group, San Diego, California, USA;6. Insight Dermatology, San Diego, California, USA;7. Case Western Reserve University School of Medicine, Cleveland, Ohio, USA;8. Division of Pediatric and Adolescent Dermatology, Rady Children's Hospital, San Diego, California, USA
Department of Dermatology and Pediatrics, University of California San Diego School of Medicine, La Jolla, California, USA |
| Abstract: | Background/ObjectivesDiagnostic criteria for atopic dermatitis (AD) are limited in their performance and/or usability. The American Academy of Dermatology (AAD) consensus criteria include hierarchical categories of disease features to improve these metrics but have not been validated. Our objective was to create and validate a checkbox form of the AAD consensus criteria in the pediatric population.MethodsWe performed a cross-sectional study of 100 pediatric patients with AD (n = 58) and diseases in the differential diagnosis of AD (n = 42).ResultsHaving three or more “Essential,” ≥2 “Important,” ≥1 “Associated” features of the AAD criteria was optimal for the diagnosis of AD in children. This combination was 91.4% (95% CI, 84.2%–98.6%) sensitive and 95.2% (88.8%–100%) specific. The UK working party criteria and the Hanifin–Rajka criteria had sensitivities of 96.6% (95% CI 91.9%–100%) and 98.3% (95% CI 94.9%–100%) and specificities of 83.3% (95% CI 72.1%–94.6%) and 71.4% (95% CI 57.8%–85.1%), respectively. The AAD criteria had significantly greater specificity than the Hanifin–Rajka criteria (p = .002).ConclusionsThis study represents an important step in validating the AAD consensus criteria and formulating a useable checkbox form for diagnosing AD in the pediatric population. |
| Keywords: | atopic dermatitis diagnostic criteria pediatrics |