Clinical manifestations of pediatric psoriasis: results of a multicenter study in the United States.
Clinical manifestations of pediatric psoriasis: results of a multicenter study in the United States.
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DOI：
10.1111/pde.12072
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发表时间：
2013-07
影响因子：
1.5
通讯作者：
Paller AS
中科院分区：
文献类型：
--
作者：
Mercy K;Kwasny M;Cordoro KM;Menter A;Tom WL;Korman N;Belazarian L;Armstrong AW;Levy ML;Paller AS
儿童银屑病的临床特点值得进一步关注。根据年龄、性别和疾病严重程度，完成了一项全国性研究，以确定头皮和指甲受累的患病率以及起病时点滴型银屑病的病史。181名年龄在5到17岁的斑块型银屑病儿童参加了一项多中心的横断面研究。受试者/监护人被问及头皮和指甲受累的历史，以及最初的表现是否有滴状。根据医生全球评估和身体表面积测量，历史上牛皮癣的严重程度被评估和定义为轻度牛皮癣(MP)或重度牛皮癣(SP)。79.0%(n=143)的受试者有头皮受累史，39.2%(n=71)的受试者有指甲受累史。男孩报告头皮受累的可能性低于女孩(OR=0.40(0.19-0.84))，但更有可能有指甲受累(OR=3.01(1.62-5.60))。头皮和指甲受累与银屑病的严重程度无关。相反，SP受试者(35.9%)比MP受试者(21.8%)更常报告有滴状皮损的病史(p=0.017)。点滴型银屑病和斑块型银屑病的儿童中，先期链球菌感染更为常见(p=0.02)，但与严重程度无关。与性别相关的头皮和指甲受累程度的差异表明，这是一种性别差异。先前的链球菌感染预测点滴状形态，但不能预测严重程度，初始点状形态与最终更严重的疾病相关，考虑到点状银屑病后来与更严重的疾病相关，应该考虑更积极的监测和治疗。
The clinical features of pediatric psoriasis warrant further attention. A national study was completed to determine the prevalence of scalp and nail involvement, and history of guttate psoriasis at onset, according to age, sex, and disease severity. 181 children, ages 5 to 17 years, with plaque psoriasis were enrolled in a multi-center, cross-sectional study. Subjects/guardians were asked about a history of scalp and nail involvement and whether the initial presentation was guttate. Peak psoriasis severity was assessed and defined historically as mild psoriasis (MP) or severe psoriasis (SP) according to Physician Global Assessment and Body Surface Area measures. 79.0% (n=143) of subjects reported a history of scalp involvement and 39.2% (n=71) described a history of nail involvement. Boys were less likely than girls to report a history of scalp involvement (OR= 0.40 (0.19-0.84)), but were more likely to have had nail involvement (OR=3.01 (1.62-5.60)). Scalp and nail involvement was not related to psoriasis severity. In contrast, SP subjects (35.9%) more often reported a history of guttate lesions than did MP subjects (21.8%) (p=0.017). Antecedent streptococcal infection was more common in children with guttate vs. plaque psoriasis at onset (p=0.02), but did not correlate with severity. Gender-related differences in scalp and nail involvement suggest koebnerization. Preceding streptococcal infection predicts guttate morphology but not severity, and initial guttate morphology is associated with eventual greater severity of disease More aggressive monitoring and management should be considered for guttate psoriasis, given its later association with more severe disease.
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影响因子：
27.4
作者：
Ash, Zoe R.;Tinazzi, Ilaria;Aydin, Sibel Z.
通讯作者：
Aydin, Sibel Z.
影响因子：
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作者：
Pariser, David M.;Bagel, Jerry;Horn, Elizabeth J.
通讯作者：
Horn, Elizabeth J.
影响因子：
6.5
作者：
Mallbris, L;Larsson, P;Ståhle, M
通讯作者：
Ståhle, M
影响因子：
--
作者：
Wilson, Floranne C.;Icen, Murat;Crowson, Cynthia S.;Mcevoy, Marian T.;Gabriel, Sherine E.;Kremers, Hilal Maradit
通讯作者：
Kremers, Hilal Maradit
影响因子：
13.8
作者：
Tollefson, Megha M.;Crowson, Cynthia S.;Kremers, Hilal Maradit
通讯作者：
Kremers, Hilal Maradit