Korean journal of dermatology (대한피부과학회지)

Korean Dermatological Association (대한피부과학회)
권호 표지

Difference in the Prevalence Rate according to Diagnostic Criteria in Atopic Dermatitis: Prevalence Rate of Atopic Dermatitis according to Hanifin-Rajka, Japanese, Korean Diagnostic Criteria and Characteristics of Three Different Diagnostic Criteria

진단기준에 따른 아토피피부염 유병률의 차이: Hanifin-Rajka, 일본인 및 한국인 진단기준에 따른 유병률의 차이 및 특징

  • Kim, Jun-Young (Department of Dermatology, Kyungpook National University School of Medicine) ;
  • Lim, Hyun-Jung (Department of Dermatology, Kyungpook National University School of Medicine) ;
  • Kim, Ho-Youn (Department of Dermatology, Kyungpook National University School of Medicine) ;
  • Lee, Won-Kee (Department of Preventive Medicine, Kyungpook National University School of Medicine) ;
  • Kim, Byung-Soo (Department of Dermatology, Pusan National University School of Medicine) ;
  • Lee, Weon-Ju (Department of Dermatology, Kyungpook National University School of Medicine) ;
  • Lee, Seok-Jong (Department of Dermatology, Kyungpook National University School of Medicine) ;
  • Kim, Do-Won (Department of Dermatology, Kyungpook National University School of Medicine)
  • 김준영 (경북대학교 의학전문대학원 피부과학교실) ;
  • 임현정 (경북대학교 의학전문대학원 피부과학교실) ;
  • 김호연 (경북대학교 의학전문대학원 피부과학교실) ;
  • 이원기 (경북대학교 의학전문대학원, 예방의학교실) ;
  • 김병수 (부산대학교 의학전문대학원 피부과학교실) ;
  • 이원주 (경북대학교 의학전문대학원 피부과학교실) ;
  • 이석종 (경북대학교 의학전문대학원 피부과학교실) ;
  • 김도원 (경북대학교 의학전문대학원 피부과학교실)
  • Received : 2010.05.21
  • Accepted : 2010.07.16
  • Published : 2010.08.30
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Abstract

Background: Although surveys on the prevalence of atopic dermatitis (AD) have been carried out worldwide, the results vary widely. The differences were probably due to the use of different diagnostic criteria. Objective: To evaluate the differences in prevalence and characteristics of AD according to various diagnostic criteria. Methods: The criteria of Hanifin and Rajka, Japanese Dermatological Association (JDA) and Korean AD diagnostic criteria were applied and compared in 733 children, aged from 3 to 6 years. Survey using questionnaires was conducted on their parents. Using these data, more precise analysis was performed about the differences in prevalence and their leading factors. Results: The prevalence rates of AD (number of the patients) were 7.9% (58/733), 8.0% (59/733), 11.2% (82/733) from Korean AD, JDA, Hanifin and Rajka diagnostic criteria, respectively. The number of children simultaneously diagnosed with AD in all three criteria was 45. According to our study, the lowest prevalence rate recorded by the Korean AD diagnostic criteria may be due to absence of the major features of "chronic relapsing dermatitis" (Youden's J index: 0.80) and the minor features of "onset of early age" (Youden's J index: 0.60). Conclusion: Through careful analysis of various AD diagnostic features, we demonstrated some diagnostically significant clinical features of AD that determine difference in prevalence. These results may be applicable in the revision of Korean AD diagnostic criteria to enable more accurate and practical diagnosis of AD in the near future.

Keywords

References

  1. Taylor B, Wadsworth J, Wadsworth M. Changes in the reported prevalence of childhood eczema since the 1939-45 war. Lancet 1984;ii:1255-1257
  2. Robertson CF, Heycock E, Bishop J. Prevalence of asthma in Melbourne school children: changes over 26 years. Br Med J 1991;302:1116-1118 https://doi.org/10.1136/bmj.302.6785.1116
  3. Meding B. Epidemiology of hand eczema in an industrial city. Acta Derm Venereol Suppl (Stockh) 1990;153:1-43
  4. Diepgen TL, Fartasch M. Recent epidemiological and genetic studies in atopic dermatitis. Acta Derm Venereol Suppl (Stockh) 1992;176:13-18
  5. Hanifin JM, Rajka G. Diagnostic features of atopic dermatitis. Acta Derm Venereol Suppl (Stockh) 1980;92: 44-47
  6. Kang KF, Tian RM. Criteria for atopic dermatitis in a Chinese population. Acta Derm Venereol Suppl (Stockh) 1989;144:26-27
  7. Tagami H. Japanese Dermatology Association criteria for the diagnosis of atopic dermatitis. J Dermatol 1995;22:966- 967 https://doi.org/10.1111/j.1346-8138.1995.tb03957.x
  8. Park YS, Kim HD, Kim KH, Kim MN, Kim JW, Ro YS, et al. Report from ADRG: a study on the diagnostic criteria of Korean atopic dermatitis. Korean J Dermatol 2006;44: 659-663
  9. Kim KH, Park CW, Eun HC, Cho SH. Eczema, In: Kye YC, Kim KH, Ryo YS, Park CW, Seo SJ, An KJ, et al, editors. Dermatology. 5th ed. Seoul: Ryomoongak, 2008: 170-178
  10. Eigenmann PA. Clinical features and diagnostic criteria of atopic dermatitis in relation to age. Pediatr Allergy Immunol 2001;12:69-74 https://doi.org/10.1034/j.1399-3038.2001.121416.x
  11. Park YM, Park HJ, Kim TY, Kim JW. The study on the hospital-based relative frequency, and clinical and laboratory findings of atopic dermatitis. Korean J Dermatol 1997;35:96-106
  12. Brenninkmeijer EEA, Schram ME, Leeflang MMG, Bos JD, Spuls PhI. Diagnostic criteria for atopic dermatitis: a systematic review. Br J Dermatol 2008;158:754-765 https://doi.org/10.1111/j.1365-2133.2007.08412.x
  13. Asher MI, Keil U, Anderson HR. International study of asthma and allergies in childhood (ISAAC): rationale and methods. Eur Respir J 1995;8:483-491 https://doi.org/10.1183/09031936.95.08030483
  14. Schultz Larsen F, Diepgen T, Svensson A. Clinical criteria in diagnosing atopic dermatitis: the Lillehammer criteria 1994. Acta Derm Venereol Suppl (Stockh) 1996;96:115-119
  15. Kim KH, Hwang JH, Park KC. Periauricular eczematization in childhood atopic dermatitis. Ped Dermatol 1996;14:278-280
  16. Lindmaier A, Lindemayr H, Schmidt JB. Dandruff-an atopic sign? Hautarzt 1987;38:138-141
  17. Williams JV, Eichenfield LF, Burke BL, Barnes-Eley M, Friedlander SF. Prevalence of scalp scaling in prepubertal children. Pediatrics 2005;115:1-6 https://doi.org/10.1542/peds.2004-1463
  18. Kwan JA, Roh KY, Koh BK, Kim JW. Clinical characteristics of adolescence and adult atopic dermatitis in Korea. Korean J Dermatol 2004;42:949-954
  19. Schultz-Larsen F, Holm NV, Henningsen K. Atopic dermatitis: a genetic-epidemiological study in a population-based twin sample. J Am Acad Dermatol 1986;15:487-494 https://doi.org/10.1016/S0190-9622(86)70198-9
  20. Seymour JL, Keswick BH, Hanifin JM. Clinical effects of diaper types on the skin of normal infants and infants with atopic dermatitis. J Am Acad Dermatol 1987;17:988-997 https://doi.org/10.1016/S0190-9622(87)70288-6
  21. Arshad SH, Matthews S, Gant S. Effects of allergen avoidance on development of allergic disorders in infancy. Lancet 1992;339:1493-1497 https://doi.org/10.1016/0140-6736(92)91260-F
  22. Hanifin JM. Clinical and basic aspects of atopic dermatitis. Semin Dermatol 1983;2:5-19
  23. Kennedy RH, Bourne WM, Dyer JA. A 48 year clinical and epidemiologic study of keratoconus. Am J Ophthalmol 1986;101:267-273 https://doi.org/10.1016/0002-9394(86)90817-2
  24. Gelmetti C. Extracutaneous manifestation of atopic dermatitis. Pediatr Dermatol 1992;9:380-382 https://doi.org/10.1111/j.1525-1470.1992.tb00637.x
  25. Svensson A, Edman B, Moller H. A diagnostic tool for atopic dermatitis based on clinical criteria. Acta Derm Venereol Suppl (Stockh) 1985;114:33-40