Eczema screening

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1], Associate Editor(s)-in-Chief: Edzel Lorraine Co, D.M.D., M.D.

Overview

Hanifin and Rajka criteria are the gold standard for diagnosing eczema.

Eczema screening

• Hanifin and Rajka criteria are the gold standard for diagnosing eczema.
• It should satisfy 3 out of 4 major criteria or 3 out of 23 minor criteria.

Table 1. Hanifin and Rajka Criteria "www.med.or.jp" (PDF).

Major Criteria	Minor Criteria
Pruritus	Xerosis
Typical morphology and distribution, flexural lichenification in adults, facial and extensor eruptions in infants and children	Ichthyosis / palmar hyper-linearity, keratosis pilaris
Chronic or chronically relapsing dermatitis	Immediate (type 1) skin-test reactivity
Personal or family history of atopy (asthma, allergic rhinitis, atopic dermatitis)	Raised serum IgE
	Early age of onset
	Tendency toward cutaneous infections (especially Staphylococcus aureus and herpes simplex virus), impaired cell-mediated immunity
	Tendency toward non-specific hand or foot dermatitis.
	Nipple eczema
	Cheilitis
	Recurrent conjunctivitis
	Dennie-Morgan infraorbital fold
	Keratoconus
	Anterior subcapsular cataracts
	Orbital darkening
	Facial pallor, facial erythema
	Pityriasis alba
	Anterior neck folds
	Itch when sweating.
	Intolerance to wool and lipid solvents.
	Perifollicular accentuation
	Food intolerance
	Course influenced by environmental or emotional factors
	White dermographism, delayed blanch.