Atopic Dermatitis In Epidemiological Investigations

The aim of this study is to evaluate the validity of the Williams' diagnostic criteria for atopic dermatitis (AD) in our country and by using the criteria to investigate the distribution of AD among youngsters at school in different parts of China to lay a baseline for observing AD epidemiological trends in coming years, serving as a clue to explore the etiology of this condition.In order to test the validity of Willams' criteria, we analyzed the data on 111 cases of AD and 121 case of dermatoses other then AD as controls sampled from outpatient settings in 3 big cities located in the south, middle and north of China , and compared the results between the Williams', the Hanifin and Rajka's (Gold Standard) and the Kang Kefei's criteria. The Williams' criteria showed the higher diagnostic efficiency compared with the Gold Standard, the sensitivity, specificity, positive predictive value and Kappa value of the Williams' criteria reaching 95.50%, 97.52%, 97.25% and 0.93 respectively. Though these values were a little bit lower than the Kang Kefei's criteria, they had no significant difference (x~2==0.69, P>0.05). While analyzing whether the index "onset under the age of 2 " is suitable to under the age of 4, we found that it would promote the diagnostic efficiency of Williams' criteria in our outpatient settings if using this index in the subject under the age of 4. The multiple indexes (pruritus plus 3 or more) of Williams' criteria in series demonstrated that the comprehensive clinical diagnostic efficiency index of the Kappa value was the highest (0.93). Our results revealed that the diagnostic efficiency was basically similar between these three criteria in our outpatient settings. However, the Williams' criteria is easy to carry out and has no invasive tests. The index of "onset under the age of 2 " can be used in all the subjects, only if conforming to the condition.In addition, we evaluated the Williams' criteria in youngsters, and surveyed the point prevalence of AD in the city of Nanjing in 1998. The results showed: (1)compared...