Chinese Journal of Dermatology ›› 2022, Vol. 55 ›› Issue (12): 1084-1088.doi: 10.35541/cjd.20220121

• Original Articles • Previous Articles     Next Articles

Evaluation of the applicability of the Zhang′s diagnostic criteria for atopic dermatitis in adolescents and adults from southern Jiangsu

Xu Wen1, Ling Xin2, Shi Xin3, Wan Congchong4, Dai Caihong5, Yang Zhigang6, Chen Lingling7   

  1. 1Department of Dermatology, Changshu No.2 People′s Hospital, Changshu 215500, Jiangsu, China; 2Department of Dermatology, Suzhou Ninth People′s Hospital, Suzhou 215200, Jiangsu, China; 3Department of Dermatology, The Second Affiliated Hospital of Soochow University, Suzhou 215004, Jiangsu, China; 4Department of Dermatology, The Third Affiliated Hospital of Soochow University, Suzhou 213000, Jiangsu, China; 5Department of Dermatology, Jiangsu Shengze Hospital, Suzhou 215227, Jiangsu, China; 6Department of Dermatology, The 904th Hospital of Joint Logistics Support Forces, Wuxi 214000, Jiangsu, China; 7Department of Dermatology, Suzhou Municipal Hospital, Suzhou 215002, Jiangsu, China
  • Received:2022-02-24 Revised:2022-08-21 Online:2022-12-15 Published:2022-12-05
  • Contact: Shi Xin; Chen Lingling E-mail:shx9@163.com; chenlingling031@126.com
  • Supported by:
    The Fifth Batch of Suzhou Health Personnel Training Projects （GSWS2019055）; The Twenty-ninth Batch of Science and Technology Development Plan （People′s Livelihood Science and Technology） Projects in Suzhou in 2020 （SS202076）

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Abstract: 【Abstract】 Objective To evaluate the applicability of the Zhang′s diagnostic criteria for atopic dermatitis （AD） in adolescents and adults from southern Jiangsu. Methods A total of 1 769 patients were collected, who were newly diagnosed with eczema or AD in departments of dermatology of 7 hospitals in southern Jiangsu from May 2019 to May 2021. A standardized survey interview was conducted with patients by dermatologists using a self-designed questionnaire, which included patient′s personal information, relevant medical history, clinical characteristics, laboratory tests, etc. Using Hanifin-Rajka criteria as the gold standard, the sensitivity and specificity of the Williams criteria, Zhang′s criteria and Japanese Dermatological Association （JDA） criteria were evaluated, separately. Results Among the 1 769 patients, there were 759 （42.9%） males and 1 010 （57.1%） females, aged 32.2 ± 8.2 years（range, 12 - 79 years）. Pruritus was the most common clinical feature among the AD patients （883/913, 96.7%）. When using the Hanifin-Rajka criteria as the gold standard, 913 （51.6%） subjects were diagnosed with AD; the sensitivity of Zhang′s criteria reached 92.6%（845/913）, and its specificity was 73.2%（627/856）; the sensitivity of Williams′ criteria was 87.8%（802/913）, and its specificity was 81.3%（696/ 856）; the sensitivity of JDA criteria reached 96.9%（885/913）, and its specificity was 68.9%（590/856）. The consistency in the diagnosis of AD was moderate between the Zhang′s criteria and Williams criteria （Kappa = 0.61, P = 0.009）, was relatively high between the Zhang′s criteria and JDA criteria （Kappa = 0.85, P = 0.001）, and was moderate between the Williams criteria and JDA criteria （Kappa = 0.51, P = 0.013）. Conclusions Compared with the Hanifin-Rajka criteria, the Zhang′s criteria exhibit good sensitivity and specificity for the diagnosis of AD among adolescents and adults in southern Jiangsu. However, pruritus remains important for the diagnosis of AD.

Key words: Dermatitis, atopic, Diagnosis, Sensitivity and specificity, Criteria, Pruritus, Immunoglobulin E, Southern Jiangsu