What are the AAD diagnostic guidelines for atopic dermatitis (eczema)?

Updated: Aug 02, 2019
  • Author: Brian S Kim, MD, MTR, FAAD; Chief Editor: William D James, MD  more...
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The following features should be considered in the diagnosis of AD in accordance with the American Academy of Dermatology (AAD) 2014 Guidelines [3] :

Essential features (must be present) are as follows:

  • Pruritus
  • Eczema (acute, subacute, chronic): (1) Typical morphology and age-specific patterns (facial/neck/extensor involvement in children, flexural involvement in any age group, sparing the groin and axillary regions); (2) chronic or relapsing history

Important features (supports the diagnosis) are as follows:

  • Early age of onset

  • Atopy: (1) Personal and/or family history; (2) IgE reactivity

  • Xerosis

Associated features (nonspecific but suggest the diagnosis of AD) are as follows:

  • Atypical vascular responses (eg, facial pallor, delayed blanch response)

  • Keratosis pilaris/pityriasis alba/hyperlinear palms/ichthyosis

  • Ocular/periorbital changes

  • Other regional findings (eg, perioral changes/periauricular lesions)

  • Perifollicular accentuation/lichenification/prurigo

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