A 6-month-old infant presents with intense itching, erythema, and weeping papules over the face and extensor surfaces of limbs. The mother has asthma. Serum IgE is markedly elevated. Which diagnostic criterion is most specific for this condition?

• A Elevated serum IgE
• B Dennie-Morgan infraorbital fold
• C Family history of atopy
• D Pruritus as a must criterion (Hanifin and Rajka) ✓

Explanation

According to the Hanifin and Rajka criteria for atopic dermatitis, pruritus is the one 'must' criterion without which the diagnosis cannot be made; additionally, three of four major criteria (personal/family history of atopy, typical morphology/distribution, chronic relapsing course, atopy) must be present. Elevated IgE, Dennie-Morgan fold, and family history of atopy are supporting (minor) criteria that add to diagnostic confidence but are not individually specific. The infantile distribution on the face and extensor surfaces is characteristic before flexural involvement in older children.

Reference: Neena Khanna Illustrated Synopsis of Dermatology & STD, 6th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.