Evaluation of a Modified Version of the United Kingdom Working Party Diagnostic Criteria for Atopic Dermatitis in Tunisia.

BACKGROUND: For many years, the United Kingdom (UK) Working Party diagnostic criteria for atopic dermatitis (AD) have represented the criteria of choice for epidemiological studies. A recent study has reported a low sensitivity of these criteria among Tunisian patients, probably because of some epidemiologic characteristics of AD in our country.

OBJECTIVE: Our objective was to validate a modified version of the UK Working Party criteria for AD in Tunisia by establishing their sensitivity, specificity, and positive predictive value and negative predictive value.

MATERIALS AND METHODS: This case-control study was performed over a period of 18 months in our dermatology department in Tunisia. The diagnosis of AD was established clinically by 2 dermatologists who specialized in dermatoallergology. Based on the UK Working Party diagnostic criteria and respecting the epidemiological peculiarities of AD in Tunisia, we proposed a modified version of diagnostic criteria adapted to Tunisian AD. The modifications concerned the first, fourth, and fifth minor criteria of the UK Working Party diagnostic criteria list.

RESULTS: We collected 156 patients and 156 controls. The mean age of AD onset was 7 years and 9 months. The inverted topography of lesions was found in 67.9% of cases. The sensitivity, specificity, positive predictive, value and negative predictive value were, respectively, 56.4%, 97.4%, 95.65%, and 69.09% for the UK Working Party diagnostic criteria and 89.1%, 95.5%, 95.1%, and 89.7% for the modified version.

CONCLUSIONS: This modified version of the UK criteria seems to be a practical diagnosis tool for AD in Tunisia.