Atopic signs and symptoms: assessing the 'atopy score' concept.

BACKGROUND

Score concepts have been suggested for the standardised diagnosis of atopic dermatitis, incorporating various anamnestic and clinical minor criteria of atopy, including the 'Erlangen Score', developed in the hospital-based setting of a dermatitis clinic.

OBJECTIVE

To evaluate the properties of this score in the context of a population-based epidemiological study.

METHODS

The association between relevant atopic criteria and previous or current flexural eczema was evaluated in 2,352 hairdressing apprentices.

RESULTS

The association was not as strong as in the patient-based studies, comparing the respective odds ratios. Accordingly, the discriminating power of the Erlangen Score was poor, resulting in low sensitivity (55.7%) and specificity (73.8%) for, e.g., 8 points as cutpoint.

CONCLUSION

While the score appears useful to summarise minor criteria, the individual relevance of its point values should not be overestimated in view of a low positive predictive value in a population (compared to a clinical) setting.