A 3-month-old presents with erythematous, weeping, and crusting lesions predominantly on the cheeks and scalp. There is no involvement of the diaper area. The mother has a history of asthma. Which of the following is a DIAGNOSTIC criterion for atopic dermatitis using the Hanifin and Rajka criteria?
- A Seborrhoeic distribution (scalp, nasolabial folds) as a major criterion
- B Positive patch test to nickel as a required criterion
- C Pruritus as a major criterion (present in all cases) ✓
- D Age of onset must be >1 year for the diagnosis to be valid
Correct answer: C. Pruritus as a major criterion (present in all cases)
Explanation
Hanifin and Rajka criteria for atopic dermatitis require ≥3 major and ≥3 minor criteria. The 4 major criteria are: (1) pruritus — present in ALL cases of AD and considered the hallmark; (2) typical morphology and distribution (facial/extensor in infants; flexural in children/adults); (3) chronic/relapsing course; (4) personal or family history of atopy. Seborrhoeic distribution is characteristic of seborrhoeic dermatitis, not AD. Patch testing for nickel is not required. AD can present from 2–3 months of age (infantile AD).
Reference: Ghai Essential Pediatrics, 10th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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