Eczema screening

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1], Associate Editor(s)-in-Chief:  Edzel Lorraine Co, D.M.D., M.D.

## Overview

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Hanifin and Rajka criteria are the gold standard for diagnosing eczema. [1] [2]

## Eczema screening

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* Hanifin and Rajka criteria are the gold standard for diagnosing eczema.
* It should satisfy 3 out of 4 major criteria or 3 out of 23 minor criteria. [3]

Table 1. Hanifin and Rajka Criteria "www.med.or.jp" (PDF). Major Criteria | Minor Criteria
Pruritus | Xerosis
Typical morphology and distribution, flexural lichenification in adults, facial and extensor eruptions in infants and children | Ichthyosis / palmar hyper-linearity, keratosis pilaris
Chronic or chronically relapsing dermatitis | Immediate (type 1) skin-test reactivity
Personal or family history of atopy (asthma, allergic rhinitis, atopic dermatitis)  | Raised serum IgE
| Early age of onset
| Tendency toward cutaneous infections (especially Staphylococcus aureus and herpes simplex virus), impaired cell-mediated immunity
| Tendency toward non-specific hand or foot dermatitis.
| Nipple eczema
| Cheilitis
| Recurrent conjunctivitis
| Dennie-Morgan infraorbital fold
| Keratoconus
| Anterior subcapsular cataracts
| Orbital darkening
| Facial pallor, facial erythema
| Pityriasis alba
| Anterior neck folds
| Itch when sweating.
| Intolerance to wool and lipid solvents.
| Perifollicular accentuation
| Food intolerance
| Course influenced by environmental or emotional factors
| White dermographism, delayed blanch.

## References

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1. ↑ Eichenfield LF, Tom WL, Chamlin SL, Feldman SR, Hanifin JM, Simpson EL; et al. (2014). "Guidelines of care for the management of atopic dermatitis: section 1. Diagnosis and assessment of atopic dermatitis". J Am Acad Dermatol. 70 (2): 338–51. doi:10.1016/j.jaad.2013.10.010. PMC 4410183. PMID 24290431.CS1 maint: Multiple names: authors list (link)
2. ↑ Schulte-Herbrüggen O, Fölster-Holst R, von Elstermann M, Augustin M, Hellweg R (2007). "Clinical relevance of nerve growth factor serum levels in patients with atopic dermatitis and psoriasis". Int Arch Allergy Immunol. 144 (3): 211–6. doi:10.1159/000103994. PMID 17579279.CS1 maint: Multiple names: authors list (link)
3. ↑ Avena-Woods C (2017). "Overview of atopic dermatitis". Am J Manag Care. 23 (8 Suppl): S115–S123. PMID 28978208.