Böhme M, Svensson A, Kull I, Wahlgren C F
Department of Dermatology, Karolinska Hospital and Institute, Stockholm, Sweden.
J Am Acad Dermatol. 2000 Nov;43(5 Pt 1):785-92. doi: 10.1067/mjd.2000.110070.
In 1980 Hanifin and Rajka published major and minor criteria for atopic dermatitis (AD). Despite the early age at onset of AD, there are few prospective studies in young children of the prevalence of signs and symptoms meeting the minor criteria.
Our purpose was to identify those of Hanifin's and Rajka's minor criteria that are most frequent in 2-year-old children with AD and in controls.
Consecutive patients with AD (n = 221), 24 months of age or younger, were followed up to 2 years, when they were re-examined. The minor criteria were divided into 33 subcriteria, 29 of which were examined. Controls (n = 99), matched for age and sex, with no history of eczema at 2 years of age were examined in the same way.
At the 2-year examination 157 of 221 had ongoing AD. Seven minor criteria were met in more than one fourth of these children, namely xerosis (100%), course influenced by environmental factors (87%), facial erythema (54%), skin reactions provoked by ingested food (39%), itch when sweating (34%), positive skin prick test (29%), and hand eczema (28%). In the control group, only xerosis (40%), facial erythema (25%), and skin reactions provoked by ingested food (9%) were present in 4% or more.
Approximately half of the 29 criteria investigated were met in 3% or fewer of the cases, indicating that they may not be of much help to the clinician. Of the minor criteria of Hanifin and Rajka, only xerosis, course influenced by environmental factors, and facial erythema were seen in a majority of patients and would therefore be useful in the diagnosis of AD.
1980年，哈尼芬（Hanifin）和拉伊卡（Rajka）发表了特应性皮炎（AD）的主要和次要标准。尽管AD发病年龄较早，但针对符合次要标准的体征和症状在幼儿中的患病率的前瞻性研究却很少。
我们的目的是确定哈尼芬和拉伊卡的次要标准中，在2岁AD患儿及对照组中最常见的标准。
对年龄在24个月及以下的连续性AD患者（n = 221）进行随访至2岁，并进行重新检查。次要标准分为33个子标准，其中29个进行了检查。年龄和性别匹配、2岁时无湿疹病史的对照组（n = 99）也以同样方式进行检查。
在2岁检查时，221例中有157例仍患有AD。超过四分之一的这些儿童符合7项次要标准，即皮肤干燥（100%）、病程受环境因素影响（87%）、面部红斑（54%）、摄入食物引起的皮肤反应（39%）、出汗时瘙痒（34%）、皮肤点刺试验阳性（29%）和手部湿疹（28%）。在对照组中，只有皮肤干燥（40%）、面部红斑（25%）和摄入食物引起的皮肤反应（9%）的出现率在4%或以上。
所研究的29项标准中约有一半在3%或更少的病例中符合，这表明它们对临床医生可能帮助不大。在哈尼芬和拉伊卡的次要标准中，只有皮肤干燥、病程受环境因素影响和面部红斑在大多数患者中可见，因此对AD的诊断可能有用。
