Dermatological findings in common rheumatologic diseases in children

The aim of this study is to outline the common dermatological findings in pediatric rheumatologic diseases. A total of 45 patients, nineteen with juvenile idiopathic arthritis (JIA), eight with Familial Mediterranean Fever (FMF), six with scleroderma (SSc), seven with systemic lupus erythematosus (SLE), and five with dermatomyositis (DM) were included. Control group for JIA consisted of randomly chosen 19 healthy subjects of the same age and gender. The age, sex, duration of disease, site and type of lesions on skin, nails and scalp and systemic drug use were recorded. χ2 test was used. The most common skin findings in patients with psoriatic JIA were flexural psoriatic lesions, the most common nail findings were periungual desquamation and distal onycholysis, while the most common scalp findings were erythema and scaling. The most common skin finding in patients with oligoarthritis was photosensitivity, while the most common nail finding was periungual erythema, and the most common scalp f indings were erythema and scaling. We saw urticarial rash, dermatographism, nail pitting and telogen effluvium in one patient with systemic arthritis; and photosensitivity, livedo reticularis and periungual erythema in another patient with RF-negative polyarthritis. Vascular skin lesions like Raynaud’s phenomenon, livedo reticularis, palmar erythema, periungual telangiectasia and nailfold abnormalities were common in SLE, DM and SSc. Patients with FMF displayed signs of atopy. Specific skin lesions can be the peculiar features of rheumatologic diseases in pediatric population. Since it is not always easy to perform biopsy in children to confirm skin involvement of a rheumatologic disease, skin findings can help both dermatologists and rheumatologists in diagnosis.

Kaynakça

Aberer E. Dermatological symptoms in rheumatology. Z Rheumatol. 2008;67:372-85.

Tenbrock K. Clinical features and therapy of rheumatic diseases and vasculitides in childhood. Hautarzt. 2014;65:802-9.

Wagner N. Cutaneous features of rheumatic diseases in childhood. Hautarzt. 2009;60:200-7.

Dobric I. Skin changes in rheumatic diseases. Reumatizam. 2005;52:9-20.

Clarke JT, Werth VP. Rheumatic manifestations of skin disease. Curr Opin Rheumatol. 2010;22:78-84.

Chua-Aguilera CJ, Möller B, Yawalkar N. Skin manifestations of rheumatoid arthritis, juvenile idiopathic arthritis, and spondyloarthritides. Clin Rev Allergy Immunol. 2017;53:371-93.

Cassano N, Amerio P, D’Ovidio R, et al. Hair disorders associated with autoimmune connective tissue diseases. G Ital Dermatol Venereol. 2014;149:555-65.

Kwiatkowska M, Rakowska A, Walecka I, et al. The diagnostic value of trichoscopy in systemic sclerosis. J Dermatol Case Rep. 2016;10:21-5.

Giancane G, Consolaro A, Lanni S, et al. Juvenile idiopathic arthritis: diagnosis and treatment. Rheumatol Ther. 2016;3:187-207.

Bronckers IM, Paller AS, van Geel MJ, et al.. Psoriasis in children and adolescents: diagnosis, management and comorbidities. Paediatr Drugs. 2015;17:373-84.

Pasch MC. Nail psoriasis: a review of treatment options. Drugs. 2016;76:675705.

Jiaravuthisan MM, Sasseville D, Vender RB, et al. Psoriasis of the nail: anatomy, pathology, clinical presentation, and a review of the literature on therapy. J Am Acad Dermatol. 2007;57:1-27.

Gilliam JN, Sontheimer RD. Distinctive cutaneous subsets in the spectrum of lupus erythematosus. J Am Acad Dermatol. 1981;4:471–5.

Bolognia JL, Jorizzo LJ, Schaffer JV, Dermatology. 3rd edition. Newyork: Saunders; 2012. pp: 615-4.

Hochberg MC, Silman AJ, Smolen JS, et al. Rheumatology. 5th edition. Philadelphia: Mosby Elsevier; 2011. pp: 250-8.

Dalakas MC. Polymyositis, dermatomyositis and inclusion-body myositis. N Engl J Med. 1991;325:1487-98.

Fisler RE, Liang MG, Fuhlbrigge RC, et al. Aggressive management of juvenile dermatomyositis results in improved outcome and decreased incidence of calcinosis. J Am Acad Dermatol. 2002;47:505-11.

Shirani Z, Kucenic MJ, Carroll CL, et al. Pruritus in adult dermatomyositis. Clin Exp Dermatol. 2004;29:273-6.

Hundley JL, Carroll CL, Lang W, et al. Cutaneous symptoms of dermatomyositis significantly impact patients’ quality of life. J Am Acad Dermatol. 2006;54:217-20.

Kwiatkowska M, Rakowska A, Walecka I, et al. The diagnostic value of trichoscopy in systemic sclerosis. J Dermatol Case Rep. 2016;10):21-5.

Grassi W, Medico PD, Izzo F, et al. Microvascular involvement in systemic sclerosis: capillaroscopic findings. Semin Arthritis Rheum. 2001;30:397402.

Kavukcu S, Türkmen M, Soylu A, et al. Skin and muscle involvement as presenting symptoms in four children with familial Mediterranean fever. Clin Rheumatol. 2009;28:857-60.

Lidar M, Doron A, Barzilai A, et al. Erysipelas like erythema as the presenting feature of familial Mediterranean fever. J Eur Acad Dermatol Venereol. 2013;27:912-5.

Cattan D. MEFV mutation carriers and diseases other than familial Mediterranean fever: proved and non-proved associations; putative biological advantage. Curr Drug Targets Inflamm Allergy. 2005;4:105-12.

Girisgen I, Sonmez F, Koseoglu K, et al. Polyarteritis nodosa and HenochSchönlein purpura nephritis in a child with familial Mediterranean fever: a case report. Rheumatol Int. 2012;32:529-33.

Alonso R, Cisteró-Bahima A, Enrique E, et al. Recurrent urticaria as a rare manifestation of familial Mediterranean fever. J Investig Allergol Clin Immunol. 2002;12:60-1.

Katipoglu B, Acehan F, Ates I. Unusual presentation of familial Mediterranean fever: atypical hyperaemic recurrent skin lesions. Clin Exp Rheumatol. 2016;34:S138.

Biçer S, Soysal DD, Ctak A, Uçsel R, Karaböcüoglu M, Uzel N. Acute colchicine intoxication in a child: A case report. Pediatr Emerg Care. 2007;23:314-7.

Güven AG, Bahat E, Akman S, et al. Late diagnosis of severe colchicine intoxication. Pediatrics. 2002;109:971-3.

Duff IF, Mikkelsen WM, Salin RW. Alopecia totalis after desacetylmethylcolchicine therapy of acute gout; report of a case. N Engl J Med. 1956;255:769–70.

Combalia A, Baliu-Piqué C, Fortea A, et al. Anagen effluvium following acute colchicine poisoning. Int J Trichology. 2016;8:171-2.

Kaynak Göster

Medicine Science
  • ISSN: 2147-0634
  • Yayın Aralığı: Yılda 4 Sayı
  • Başlangıç: 2012

14.3b8.3b

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