Williams H C, Burney P G, Pembroke A C, Hay R J
St John's Institute of Dermatology, London, U.K.
Br J Dermatol. 1994 Sep;131(3):406-16. doi: 10.1111/j.1365-2133.1994.tb08532.x.
In order to qualify as a case of atopic dermatitis, we propose that an individual must have an itchy skin condition plus three or more of the following: history of flexural involvement, a history of asthma/hay fever, a history of a generalized dry skin, onset of rash under the age of 2 years, or visible flexural dermatitis. When tested in an independent sample of 200 consecutive dermatology outpatients of all ages, this arrangement of the diagnostic criteria achieved 69% sensitivity and 96% specificity when validated against physician's diagnosis. Based on the findings of this first exercise, minor modifications in the wording of the criteria were undertaken, and these were tested on a sample of 114 consecutive children attending out-patient paediatric dermatology clinics. Overall discrimination improved, with a sensitivity of 85% and specificity of 96%. The simplified criteria are easy to use, take under 2 min per patient to ascertain, and do not require subjects to undress. These two independent validation studies suggest that the newly proposed criteria for atopic dermatitis perform reasonably well in hospital out-patient patients. Further validation in community settings and in developing countries is needed.
为了符合特应性皮炎的病例标准，我们提议个体必须有皮肤瘙痒状况，并且具备以下三项或更多：屈侧受累史、哮喘/花粉热病史、全身性皮肤干燥病史、2岁前出现皮疹，或可见的屈侧皮炎。在对200名各年龄段连续就诊的皮肤科门诊患者的独立样本进行测试时，根据医生的诊断进行验证，这种诊断标准组合的灵敏度达到69%，特异度达到96%。基于首次试验的结果，对标准的措辞进行了细微修改，并在114名连续就诊于儿科皮肤科门诊的儿童样本中进行了测试。总体鉴别能力有所提高，灵敏度为85%，特异度为96%。简化后的标准易于使用，每位患者确定标准所需时间不到2分钟，且无需受试者脱衣。这两项独立的验证研究表明，新提议的特应性皮炎标准在医院门诊患者中表现相当不错。还需要在社区环境和发展中国家进行进一步验证。
