RECENT study highlighted significant improvements in diagnosing atopic dermatitis (AD) among infants with diverse skin tones, with the use of picture-based scorecards. This tool fills in the gaps in the gold standard for evaluating AD in infants with varying skin tones, which has been a long-standing challenge in dermatology.
A scorecard was developed by researchers at the Northwestern Feinberg School of Medicine, it featured photographs of infants with different skin tones, which aimed to help paediatricians accurately diagnose and categorise the severity of AD, thereby facilitating early intervention and better management of the condition.
The research team recruited 13 infants from clinics at Lurie Children’s Hospital between August 2019 and April 2020. The team took standardised dermatologic photographs of six infants, while parents provided photographs of the remaining seven. Dermatologists then evaluated these photographs, agreeing on the severity of AD in 84% of cases on the first pass. The finalised scorecard includes images of infants with mild, moderate, and severe AD, covering a range of skin tones: two White infants, two Black infants, one mixed-race infant, and two Hispanic/Latino infants.
The scorecard was distributed to 159 paediatricians, with 110 responding to a survey about its usefulness. The results showed that 53.7% of respondents found the scorecard either “very” or “extremely” helpful. 35.5% reported it “moderately” improved their ability to diagnose and categorise AD. 44.5% reported that they “sometimes” used the scorecard, while 10% used it “very often” or “always.”
AD affects up to 20% of children, with a significant proportion also experiencing food allergies. Early and accurate diagnosis of AD is crucial as it allows for better management of the disease, which can improve sleep, quality of life, and reduce the risk of associated conditions like food allergies and asthma. The study suggests that using a picture-based scorecard could help paediatricians diagnose AD more effectively, particularly in infants with diverse skin tones.
The researchers plan to continue collecting photographs of infants with diverse skin tones to further enhance the scorecard’s accuracy and utility. This study demonstrates a significant step forward in paediatric dermatology, offering a practical solution to a previously unmet need in the diagnosis and management of atopic dermatitis across varied skin tones.
Aleksandra Zurowska, EMJ
Reference
Samady W et al. Developing an infant atopic dermatitis scorecard for pediatric clinicians. Ann Allergy Asthma Immunol. 2024.[Epub ahead of print].
