A 5-year-old child is brought with intensely pruritic, dry, lichenified patches on the antecubital and popliteal fossae since infancy. The mother has bronchial asthma. Serum IgE is markedly elevated. Which of the following features, if present, would be considered a MAJOR diagnostic criterion for this condition according to Hanifin and Rajka criteria?
- A Elevated serum IgE
- B Pruritus ✓
- C Early age of onset
- D Tendency toward skin infections
Correct answer: B. Pruritus
Explanation
The Hanifin and Rajka criteria for atopic dermatitis include 4 major and 23 minor criteria; diagnosis requires 3 major plus 3 minor criteria. The 4 major criteria are: (1) pruritus, (2) typical morphology and distribution (flexural lichenification in adults; facial and extensor involvement in infants), (3) chronic or relapsing course, and (4) personal or family history of atopy. Elevated IgE, early age of onset, and susceptibility to infections are all minor criteria.
Reference: Neena Khanna Illustrated Synopsis of Dermatology & STD, 6th ed.
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