Section : Conference Notes

Defining (D) Atopic Dermatitis (AD) And Measuring Its Impact (I) (For Professionals)

Defining (D) Atopic Dermatis (AD) And Measuring Its Impact (I) (For Professionals)


Is termed eczema which to divide in atopic and non atopic.

The other type is contact dermatitis (allergic or non allergic). 2004

What is a good definition ?:

  • It is valid
  • It is repeatable
  • It is accepted by others
  • It is easy to define
  • It makes sense (coherence)

Many different tools have been used to define atopic dermatitis (AD):

  • The Most famous: Hanifin et Rajka (H & R)
  1. 3 major elements: pruritus, lichenification, chronic relapsing course, personal family history
  2. 3 minor elements: dry skin, ichtyosis…..over 20 elements
  • Then: UK refinement of H & R criteria
  1. Itch
  2. plus 3 or more of:
  1. flexural involvement
  2. family history of flexural involvement
  3. history of dry skin
  4. beginning before 2 years of age (not valid if beginning after 4 years of age)
  • many other tools exist: millenium criteria (IgE), danish….to conclude a widely accepted common diagnostic tool is lacking and until this happens, it will be difficult to compare studies and measure them according to one’s own practice.


  • Frequency of AD
  1. More frequent in affluent countries: more than 15% of the childhood population in the UK, Finland, Sweden. More than 10% of the childhood population in New Zealand and Central Europe.
  2. Quite interestingly though there has been a strong increase in SE Asia (where the prevalence was low) and generally in urban areas.
  3. Concerning Adult AD: its prevalence among the population is about 10% in Europe and other countries such as Thailand
  • AD has a poor prognosis and risks continuing in adulthood:
  1. if early onset
  2. if severe in signs and symptoms…
  3. Overall 40%-60% of childhood AD persists into adulthood
  4. Of those having had childhood AD,  1/4 keep to have hand eczema as adults
  • Costs of AD
  1. In European countries, the brunt of the cost is carried by families (465 million pounds each year in the UK) rather than the social welfare system
  • Quality of life (QoL) impairement:
  1. increased anxiety among patients with atopic dermatitis
  2. increased stress among patients with atopic dermatitis
  3. higher prevalence of depression among patients with atopic dermatitis
  4. avoidance of certain jobs: 40% of patients with AD do so.


Dr Christophe HSU – dermatologist. Geneva, Switzerland

Source of information: Flohr C. Definition and burden of AD. 19th Congress of the European Academy of Dermatology and Venereology (EADV) – Gothenburg (Göteborg), Sweden (Sverige).

Category : adultes - Modifie le 10.10.2010Category : adults - Modifie le 10.10.2010Category : atopic dermatitis - Modifie le 10.10.2010Category : burden - Modifie le 10.10.2010Category : définition - Modifie le 10.10.2010Category : dermatite atopique - Modifie le 10.10.2010Category : poids émotionnel - Modifie le 10.10.2010