Leg ulcers in childhood: A multicenter study in France.


Journal

Annales de dermatologie et de venereologie
ISSN: 0151-9638
Titre abrégé: Ann Dermatol Venereol
Pays: France
ID NLM: 7702013

Informations de publication

Date de publication:
Mar 2022
Historique:
received: 12 01 2021
revised: 30 03 2021
accepted: 19 05 2021
pubmed: 6 7 2021
medline: 23 2 2022
entrez: 5 7 2021
Statut: ppublish

Résumé

Leg ulcers in adults are a major public health concern. Their incidence increases with age and many causes have been identified, predominantly associated with vascular diseases. Leg ulcers in children and teenagers are less frequent. The aim of our study was to identify the causes of leg ulcers in children and teenagers, and to evaluate their management. This retrospective multicenter study was conducted by members of the Angio-dermatology Group of the French Society of Dermatology and of the French Society of Pediatric Dermatology. Data from children and teenagers (< 18 years), seen between 2008 and 2020 in 12 French hospitals for chronic leg ulcer (disease course>4 weeks), were included. We included 27 patients, aged from 2.3 to 17.0 years. The most frequent causes of leg ulcer were: general diseases (n=9: pyoderma gangrenosum, dermatomyositis, interferonopathy, sickle cell disease, prolidase deficiency, scleroderma, Ehlers-Danlos syndrome), vasculopathies (n=8: hemangioma, capillary malformation, arteriovenous malformation), trauma (n=4: bedsores, pressure ulcers under plaster cast), infectious diseases (n=4: pyoderma, tuberculosis, Buruli ulcer) and neuropathies (n=2). Comorbidities (59.3%) and chronic treatments (18.5%) identified as risk factors for delayed healing were frequent. The average time to healing was 9.1 months. Leg ulcers are less frequent in children and teenagers than in adults and their causes differ from those in adults. Comorbidities associated with delayed healing must be identified and managed. Children and teenagers tend to heal faster than adults, but a multidisciplinary management approach is necessary.

Sections du résumé

BACKGROUND BACKGROUND
Leg ulcers in adults are a major public health concern. Their incidence increases with age and many causes have been identified, predominantly associated with vascular diseases. Leg ulcers in children and teenagers are less frequent. The aim of our study was to identify the causes of leg ulcers in children and teenagers, and to evaluate their management.
METHODS METHODS
This retrospective multicenter study was conducted by members of the Angio-dermatology Group of the French Society of Dermatology and of the French Society of Pediatric Dermatology. Data from children and teenagers (< 18 years), seen between 2008 and 2020 in 12 French hospitals for chronic leg ulcer (disease course>4 weeks), were included.
RESULTS RESULTS
We included 27 patients, aged from 2.3 to 17.0 years. The most frequent causes of leg ulcer were: general diseases (n=9: pyoderma gangrenosum, dermatomyositis, interferonopathy, sickle cell disease, prolidase deficiency, scleroderma, Ehlers-Danlos syndrome), vasculopathies (n=8: hemangioma, capillary malformation, arteriovenous malformation), trauma (n=4: bedsores, pressure ulcers under plaster cast), infectious diseases (n=4: pyoderma, tuberculosis, Buruli ulcer) and neuropathies (n=2). Comorbidities (59.3%) and chronic treatments (18.5%) identified as risk factors for delayed healing were frequent. The average time to healing was 9.1 months.
DISCUSSION CONCLUSIONS
Leg ulcers are less frequent in children and teenagers than in adults and their causes differ from those in adults. Comorbidities associated with delayed healing must be identified and managed. Children and teenagers tend to heal faster than adults, but a multidisciplinary management approach is necessary.

Identifiants

pubmed: 34218940
pii: S0151-9638(21)00062-4
doi: 10.1016/j.annder.2021.05.004
pii:
doi:

Types de publication

Journal Article Multicenter Study

Langues

eng

Sous-ensembles de citation

IM

Pagination

51-55

Informations de copyright

Copyright © 2021 Elsevier Masson SAS. All rights reserved.

Auteurs

M Say (M)

Service de dermatologie et médecine vasculaire, hôpital Victor-Dupouy, 69, rue du Lieutenant-Colonel Prud'hon, 95100 Argenteuil, France. Electronic address: matthieu.say@ch-argenteuil.fr.

E Tella (E)

Service de dermatologie et médecine vasculaire, hôpital Victor-Dupouy, 69, rue du Lieutenant-Colonel Prud'hon, 95100 Argenteuil, France.

O Boccara (O)

Service de dermatologie, centre hospitalier universitaire Necker-Enfants Malades, AP-HP, Paris, France.

M Sauvage (M)

Service de dermatologie, centre de référence des Maladies Rares de la Peau, centre hospitalier universitaire Larrey, Université Paul-Sabatier, Toulouse, France.

E Bourrat (E)

Service de pédiatrie générale, centre hospitalier universitaire Robert-Debré, AP-HP, Paris, France.

Y Tian (Y)

Service de pédiatrie générale, centre hospitalier universitaire Robert-Debré, AP-HP, Paris, France.

J-B Monfort (JB)

Service de dermatologie, centre hospitalier universitaire Tenon, AP-HP, Paris, France.

C Lok (C)

Service de dermatologie, centre hospitalier universitaire Amiens-Picardie, Amiens, France.

F Desierier (F)

Service de dermatologie, centre hospitalier universitaire Amiens-Picardie, Amiens, France.

N Beneton (N)

Service de dermatologie, centre hospitalier du Mans, Le Mans, France.

C Abasq-Thomas (C)

Service de dermatologie, centre hospitalier Régional Universitaire de Brest, Brest, France.

I Kupfer-Bessaguet (I)

Service de dermatologie, centre hospitalier de Niort, Niort, France.

S Mallet (S)

Service de dermatologie, centre hospitalier universitaire La Timone, Assistance Publique des Hôpitaux de Marseille, Marseille, France.

J-P Lacour (JP)

Service de dermatologie, centre hospitalier universitaire L'archet, Nice, France.

P Plantin (P)

Service de dermatologie, centre hospitalier de Cornouaille, Quimper, France.

M-L Sigal (ML)

Service de dermatologie et médecine vasculaire, hôpital Victor-Dupouy, 69, rue du Lieutenant-Colonel Prud'hon, 95100 Argenteuil, France.

J Mazereeuw-Hautier (J)

Service de dermatologie, centre de référence des Maladies Rares de la Peau, centre hospitalier universitaire Larrey, Université Paul-Sabatier, Toulouse, France.

E Mahé (E)

Service de dermatologie et médecine vasculaire, hôpital Victor-Dupouy, 69, rue du Lieutenant-Colonel Prud'hon, 95100 Argenteuil, France.

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Classifications MeSH