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  Authority of Polish Society of Allergology

vol 14. no 4. December 2009  

 Review articles
Atopic dermatitis – differential diagnosis of the skin lesions
Anna Brucka-Stempkowska, Dagmara Kubik, Aleksandra Lesiak, Joanna Narbutt

Atopic dermatitis (AD) is a chronic inflammatory skin disorder with
severe, recurrent pruritus, and is characterized by periods of remission
and relapses. In a clinical practice the diagnosis is made using
the most common criteria recommended by Hanifin and Rajka which
include the picture of skin lesions, medical history and selected
laboratory parameters. This procedure may lead to more frequent
diagnosis of the disease than really occurs, especially in the cases
where not all clinical features are present. This statement raises the
question whether AD is not over-diagnosed, especially in children under
1 year of life. Diagnostic mistakes leading to incorrect treatment
usually result from insufficient differential diagnosis. The aim of the
article is to discuss diseases which may imitate skin lesions typical
for atopic eczema occurring in three age-related stages. The article
draws our attention to unnecessary diagnostic mistakes, which exacerbate
patients’ prognosis and reduce their comfort of life. Clinical
experience shows that the diagnosis of AD is problematic. Therefore,
physicians are required to have a huge knowledge of dermatological
disorders, and to perform additional tests, especially histopathology
of the skin.

keywords: atopowe zapalenie skóry, diagnostyka różnicowa, nadrozpoznawalność, obraz kliniczny, badania dodatkowe, atopic dermatitis, differential diagnosis, over-diagnosis, clinical manifestation, additional tests

pages: from 223 to 229

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