Pediatric Psoriasis Comorbidity Screening Guidelines.
Pediatric Psoriasis Comorbidity Screening Guidelines.
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DOI：
10.1001/jamadermatol.2017.0499
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发表时间：
2017-07-01
期刊：
影响因子：
10.9
通讯作者：
Eichenfield LF
中科院分区：
文献类型：
--
作者：
Osier E;Wang AS;Tollefson MM;Cordoro KM;Daniels SR;Eichenfield A;Gelfand JM;Gottlieb AB;Kimball AB;Lebwohl M;Mehta NN;Paller AS;Schwimmer JB;Styne DM;Van Voorhees AS;Tom WL;Eichenfield LF
银屑病是一种复杂的炎症性皮肤病，与成人严重的医学合并症相关，包括肥胖、高血压、血脂异常、2型糖尿病、银屑病关节炎、非酒精性脂肪肝、抑郁、焦虑和生活质量下降。由于近三分之一的患者在儿童时期就开始患银屑病，因此早期识别风险对于尽量减少对未来健康的影响至关重要。根据现有证据制定第一套儿童银屑病患者合并症筛查指南。使用PubMed进行了1999年1月至2015年12月的文献综述。将检索限制在以英语发表的人类研究中，并删除评论和社论，产生了153篇相关手稿。银屑病、儿科皮肤病学、儿科风湿病学、儿科胃肠病学、儿科内分泌学以及成人和儿科心脏病学的专家小组使用以患者为中心的推荐强度分类法（SORT）对证据质量进行评价和分级。由于发表的关于这些主题的儿科研究数量有限，专家组建议的强度被归类为SORT C级专家共识建议。大多数建议与美国儿科学会认可的一般儿科患者一致，但增加了对关节炎，抑郁和焦虑的体征和症状的关注。专家组还确定了需要进一步调查的关键领域。儿童银屑病患者应接受常规筛查，并确定相关合并症的危险因素。这些指南适用于所有护理儿童银屑病患者的医疗保健提供者，包括初级保健临床医生，皮肤科医生和儿科专家。因为这是第一个儿科指南，随着研究的进一步详细，并可能分层，受影响儿童的风险，重新审查和完善将是必要的。
Psoriasis is a complex inflammatory skin condition associated with serious medical comorbidities in adults, including obesity, hypertension, dyslipidemia, type 2 diabetes mellitus, psoriatic arthritis, nonalcoholic fatty liver disease, depression, anxiety, and decreased quality of life. Because psoriasis begins in childhood in almost one-third of patients, early identification of risk may be critical to minimizing effects on future health. To develop the first set of guidelines for comorbidity screening for patients with pediatric psoriasis based on current evidence. A literature review was performed using PubMed from January 1999 through December 2015. Limiting the search to human studies published in English and removing reviews and editorials produced 153 relevant manuscripts. An expert panel in psoriasis, pediatric dermatology, pediatric rheumatology, pediatric gastroenterology, pediatric endocrinology, and adult and pediatric cardiology used the patient-centered Strength of Recommendation Taxonomy (SORT) method to evaluate and grade the quality of evidence. Because of the limited number of pediatric studies published on these topics, the strength of the panel’s recommendations is classified as SORT level C expert consensus recommendations. The majority of recommendations coincide with those endorsed by the American Academy of Pediatrics for the general pediatric patient but with added attention to signs and symptoms of arthritis, depression, and anxiety. The panel also identified key areas for further investigation. Patients with pediatric psoriasis should receive routine screening and identification of risk factors for associated comorbidities. These guidelines are relevant for all health care providers caring for patients with pediatric psoriasis, including primary care clinicians, dermatologists, and pediatric specialists. Because these are the first pediatric guidelines, re-review and refinement will be necessary as studies further detail, and possibly stratify, risk in affected children.
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影响因子：
120.7
作者：
Gelfand, Joel M.;Neimann, Andrea L.;Troxel, Andrea B.
通讯作者：
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Barlow, Sarah E.
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