Diagnostic aspects of atopic dermatitis

Atopic dermatitis (AD) is a chronic recurrent inflammatory skin disease that is often familial. Atopic dermatitis leads among all dermatological diagnoses that pediatricians give their patients. There is a tendency to over diagnosis of this dermatosis, which, in turn, determines the vector of research aimed at developing more accurate algorithms for making the correct diagnosis. Currently, there are various diagnostic schemes based on the summation of major and minor AD criteria. If patients have major signs of the disease, the diagnosis of AD does not cause any particular difficulties, however, current diagnostic trends are associated with focusing on minor criteria, that are especially important in subacute, chronic course and incomplete remission. This article presents relevant data on the role of genetic factors in AD development. It describes in detail the AD pathogenesis, where the main role is played by epidermal barrier lesion due to filaggrin protein mutation and body immune dysfunction, and, as a result, the predisposition of patients with AD to skin infection with pathogenic microorganisms. It gives a brief description of AD clinical picture depending on the age of the patient. Special attention is paid to various diagnostic algorithms for AD, among which the most recognized are J.M. Hanifin and G. Rajka diagnostic criteria (1980). All minor AD criteria from this algorithm are described in detail, authors also proposed additional signs of the disease that will help pediatricians to diagnose AD more accurately and select therapy for patients. Considering the fact that skin barrier dysfunction is the basis of this dermatosis, the article shows the high importance of emollients and regenerating agents, affecting the main pathogenesis links. © 2020, Pediatria Ltd.. All rights reserved.