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

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