Centre of Evidence Based Dermatology

UK Diagnostic Criteria for Atopic Dermatitis

This practical manual and test were developed by Professor Hywel Williams, Director of the Centre of Evidence Based Dermatology at The University of Nottingham, with help from Dr Carsten Flohr.

NB: The second question of the adult (16 years +) version of the criteria reading “How old were you when this skin condition began?” has an answer box reading "5 to 10." This should actually be "6 to 10." This will be amended in the near future. 


Frequently asked questions

1. What are the UK Diagnostic Criteria?
These are criteria used to diagnose atopic eczema/atopic dermatitis in epidemiological and clinical studies. They are a much shorter, reliable and valid refinement of the original Hanifin and Rajka diagnostic criteria.
2. Why do we need these criteria?
In order to define a clear phenotype than can be compared in population and clinical studies.
3. Who needs to use the criteria?  
The main use will be studies trying to document the burden and causes of atopic eczema/atopic dermatitis. They are also used extensively in clinical trials. They can also be used as a guide to aid clinical diagnosis in the community as in the NICE guidelines.
4. The criteria were developed in the early 1990s. Are they still valid today?
The criteria remain the most extensively validated instrument for measuring atopic eczema/dermatitis. (See independent systematic review.)
5. What is the purpose of the test?
As with any instrument, a user needs to be able to use it properly. To help you understand what the sign of "visible flexural dermatitis looks like", we have included a set of training photographs. Once you are confident in understanding what this sign is, we then encourage you to take the quality control test to make sure that you are recording that important sign reliably.
6. Who needs to take the test?
Any researcher or field worker who will be examining people to see if they have atopic eczema/atopic dermatitis.
7. What happens after I take the test?
You will get a personalised feedback on whether you have passed the test or not. Make sure you get lots of practice first as the quality control test can only be taken once.
8. Are there any translations of the scale available?

We have a few translations available:

Filipino translation
(courtesy of Rowena F. Genuino, MD, FPDS and Maria Sharlene O. Pelino, MD)

Spanish (US) translation for under 16s and 16 and over
(courtesy of TARGET PharmaSolutions - certification)

French (France) translation for under 16s  and 16 and over
(courtesy of TARGET PharmaSolutions - certification)

Italian (Italy) translation for under 16s  and 16 and over
(courtesy of TARGET PharmaSolutions - certification)

French (Canada) translation for under 16s (certification) and 16 and over (certification
(courtesy of TARGET PharmaSolutions)

Germany (Germany) translation for under 16s (certification) and 16 and over (certification
(courtesy of TARGET PharmaSolutions)

9. Can the criteria be assessed entirely remotely by questionnaire?

Yes – assessment of the sign of visible flexural dermatitis (the only criterion to require face to face evaluation) can be assessed reliably as shown in the following independent publication:

Fleming S, Bodner C, Devereux G, Russell G, Campbell D, Godden D, Seaton A. An application of the United Kingdom Working Party diagnostic criteria for atopic dermatitis in Scottish infants. J Invest Dermatol. 2001 Dec;117(6):1526-30. doi: 10.1046/j.0022-202x.2001.01579.x. PMID: 11886518.



Centre of Evidence Based Dermatology

The University of Nottingham
Applied Health Research Building
University Park, Nottingham

telephone: +44 (0) 115 84 68631
email: cebd@nottingham.ac.uk