Study on usage of various criterias in the diagnosis of Atopic Eczema among South Indian population

Abstract

Atopic Eczema (AE) is a specific chronic relapsing dermatitis with varied presentations. The etiopathogenesis of AE is largely speculative and over years has led to origin of various criteria like Hanifin, Rajka’s criteria (HRC), United Kingdom working party’s diagnostic criteria (UKWPDC) and millennium diagnostic criteria (MDC). These have originated in western countries and is used among Indian population without much validation studies. To validate HRC, UKWPDC and MDC in the diagnosis of AE among Indian population. A case-control study including 50 cases of AE and 30 age matched controls who are presenting to the DVL OPD of a tertiary teaching hospital. Defined case proforma was prepared highlighting the criteria’s of HRC, UKWDPC and MDC posing as a questionnaire to the cases/subjects. Total Serum IgE levels were estimated. Sensitivity, specificity, Positive predictive value (PPV), Negative predictive value (NPV) and Relative value were calculated for all criteria. The Sensitivity, specificity, PPV and NPV was 100% for HRC and UKWPDC whereas there was a compromise in the specificity (32.5%) and lower relative value of (22.5%) for MDC. Some minor features of HRC and MDC criteria showed lower validity compared to major features. Though many upgradations are going on in HRC, UKWPDC it could still be considered and used as a diagnostic criterion considering the high sensitivity, specificity and accuracy for diagnosis of AE.