Department of Dermatology, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands.
J Dermatol. 2011 Sep;38(9):850-8. doi: 10.1111/j.1346-8138.2011.01202.x. Epub 2011 Mar 31.
There is no gold standard for a definite diagnosis of atopic dermatitis. For the time being, several lists of diagnostic criteria have been proposed, some of them in actual use. The Millennium Criteria have been proposed to diagnose atopic dermatitis and to differentiate it from atopiform dermatitis. Our aim was to further refine the Millennium Criteria into a manageable set that can differentiate between atopic and atopiform dermatitis and other entities. The hereby refined Millennium Criteria will be compared with the UK Working Party Criteria and the Hanifin & Rajka Criteria. Data of 210 included patients were used. After multiple logistic regression, a minimum set of five criteria was identified as best discriminators: (i) typical morphology; (ii) early age of onset; (iii) Dennie-Morgan fold; (iv) historical and (v) actual flexural involvement. The refined Millennium Criteria were constituted from these criteria. When comparing the different list for validity in diagnosing atopic dermatitis, the refined Millennium Criteria showed a sensitivity of 81.8% and a specificity of 98.8% compared to a sensitivity of 97.7% and specificity of 72.9% of the UK Criteria and a sensitivity of 100% and specificity of 48.8% of the Hanifin & Rajka Criteria. This refinement and validity study shows that the refined Millennium Criteria are a valid tool to diagnose atopic and atopiform dermatitis in a hospital-based setting and therefore could be incorporated in clinical practice and trials.
目前，尚无特应性皮炎明确诊断的金标准。为此，已经提出了一些诊断标准列表，其中一些正在实际应用中。千年标准被提议用于诊断特应性皮炎，并将其与特应性样皮炎区分开来。我们的目的是进一步完善千年标准，使之成为一个易于管理的标准，能够区分特应性皮炎和特应性样皮炎以及其他疾病。本文中完善的千年标准将与英国工作组标准和 Hanifin & Rajka 标准进行比较。共纳入 210 例患者的数据。经过多项逻辑回归分析，确定了最佳的五个鉴别标准：（i）典型形态；（ii）发病年龄早；（iii）Dennie-Morgan 皱褶；（iv）既往和（v）实际屈侧受累。改良的千年标准就是由这些标准组成的。在比较不同标准对特应性皮炎的诊断有效性时，改良的千年标准的敏感性为 81.8%，特异性为 98.8%，而英国标准的敏感性为 97.7%，特异性为 72.9%，Hanifin & Rajka 标准的敏感性为 100%，特异性为 48.8%。这项完善和有效性研究表明，改良的千年标准是在医院环境中诊断特应性和特应性样皮炎的有效工具，因此可以纳入临床实践和试验中。
