Practice-based differences in paediatric discoid lupus erythematosus.
Antibodies, Antinuclear
/ blood
Child
Consensus
Dermatologists
/ statistics & numerical data
Dermatology
/ standards
Disease Progression
Humans
Lupus Erythematosus, Discoid
/ diagnosis
Lupus Erythematosus, Systemic
/ epidemiology
Mass Screening
/ standards
Practice Guidelines as Topic
Practice Patterns, Physicians'
/ standards
Rheumatologists
/ statistics & numerical data
Rheumatology
/ standards
Risk Factors
Surveys and Questionnaires
/ statistics & numerical data
Journal
The British journal of dermatology
ISSN: 1365-2133
Titre abrégé: Br J Dermatol
Pays: England
ID NLM: 0004041
Informations de publication
Date de publication:
10 2019
10 2019
Historique:
accepted:
13
02
2019
pubmed:
16
2
2019
medline:
21
10
2020
entrez:
16
2
2019
Statut:
ppublish
Résumé
Children with discoid lupus erythematosus (DLE) are at risk for disfigurement and progression to systemic lupus erythematosus (SLE). Consensus is lacking regarding optimal care for children with DLE. The aim of this study was to compare practice patterns among paediatric dermatologists/rheumatologists treating paediatric DLE. An online survey was sent to 292 paediatric rheumatologists in the Childhood Arthritis and Rheumatology Research Alliance and 200 paediatric dermatologists in the Pediatric Dermatology Research Alliance. Consensus was defined as ≥ 70% agreement. Survey response rates were 38% (76 of 200) for dermatology and 21% (60 of 292) for rheumatology. Both specialties agreed that screening labs should include complete blood counts with differential, urinalysis, complement levels, erythrocyte sedimentation rate, antinuclear antibody and other autoantibodies, hepatic function and renal function/electrolytes. Both specialties agreed that arthritis or nephritis should prompt intensified evaluation for SLE. No other patient features achieved consensus as disease-modifying risk factors. Hydroxychloroquine was agreed upon as first-line systemic therapy, but consensus was lacking for second- or third-line treatment. We found few areas of consensus and significant practice differences between paediatric dermatologists and rheumatologists treating DLE. Knowledge gaps include risk factors for SLE, optimal screening and treatment of refractory skin disease.
Sections du résumé
BACKGROUND
Children with discoid lupus erythematosus (DLE) are at risk for disfigurement and progression to systemic lupus erythematosus (SLE). Consensus is lacking regarding optimal care for children with DLE.
OBJECTIVES
The aim of this study was to compare practice patterns among paediatric dermatologists/rheumatologists treating paediatric DLE.
METHODS
An online survey was sent to 292 paediatric rheumatologists in the Childhood Arthritis and Rheumatology Research Alliance and 200 paediatric dermatologists in the Pediatric Dermatology Research Alliance. Consensus was defined as ≥ 70% agreement.
RESULTS
Survey response rates were 38% (76 of 200) for dermatology and 21% (60 of 292) for rheumatology. Both specialties agreed that screening labs should include complete blood counts with differential, urinalysis, complement levels, erythrocyte sedimentation rate, antinuclear antibody and other autoantibodies, hepatic function and renal function/electrolytes. Both specialties agreed that arthritis or nephritis should prompt intensified evaluation for SLE. No other patient features achieved consensus as disease-modifying risk factors. Hydroxychloroquine was agreed upon as first-line systemic therapy, but consensus was lacking for second- or third-line treatment.
CONCLUSIONS
We found few areas of consensus and significant practice differences between paediatric dermatologists and rheumatologists treating DLE. Knowledge gaps include risk factors for SLE, optimal screening and treatment of refractory skin disease.
Substances chimiques
Antibodies, Antinuclear
0
Types de publication
Comparative Study
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
805-810Commentaires et corrections
Type : CommentIn
Informations de copyright
© 2019 British Association of Dermatologists.
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