Original paper
The role of minor Hanifin and Rajka criteria in diagnosis of atopic dermatitis patients

Aim: The main purpose of the study was to analyze the frequency and diagnostic significance of the clinical features of atopic dermatitis. An analysis of the frequency of minor features depending on severity of skin inflammation was performed. The correlation between total serum IgE level and clinical state, evaluated on the basis of W-AZS index, was assessed.
Material and methods: 50 patients (aged 5-52 years) were investigated. In all patients clinical examination included Hanifin and Rajka criteria. Evaluation of clinical score was based on W-AZS index. Total serum IgE level was measured with fluoroimmunoenzyme assay (Uni-Cap, Pharmacia). The control group consisted of 25 healthy individuals.
Results: 4 major features of Hanifin and Rajka were registered in 68% of patients – pruritus was present in all cases. The incidence of minor criteria appeared with varying frequency from 0 to 96% – xerosis was the most common. W-AZS score was statistically significantly higher in patients with elevated total IgE level and in patients who presented more minor features in clinical examination. In severe AD patients white dermographism was observed in 83%.
Conclusions: Pruritus and xerosis are the most common diagnostic features of AD. Anterior neck folds, ichthyosis, cataracts, and keratoconus could be recognized as features with lower diagnostic significance. White dermographism is a significant feature of AD and correlates with severity of the disease. Severity of skin inflammation correlates with the number of minor criteria. Level of total IgE correlates with the clinical severity of atopic dermatitis. Severity of skin inflammation was higher in patients with AD as the only represented disease.