Kuwabara Anne M, Rainer Barbara M, Basdag Hatice, Cohen Bernard A
Division of Pediatric Dermatology, Departments of Pediatrics and Dermatology, School of Medicine, Johns Hopkins University, Baltimore, Maryland.
Pediatr Dermatol. 2015 Sep-Oct;32(5):679-83. doi: 10.1111/pde.12584. Epub 2015 Apr 15.
The purpose is to investigate the demographics and course of common warts in children in an outpatient setting.
A retrospective medical chart review and telephone survey study were completed on an outpatient cohort of children (0-17 yrs) with a clinical diagnosis of warts at a single-center, university-based pediatric dermatology practice. The main outcome measures included management, time to resolution, and associated factors of warts in children.
Of the 254 patients we contacted, 214 agreed to participate in the survey. The most commonly involved sites were the hands and the head and neck area. Most children received some form of therapy, but it is unclear that any form of treatment altered the course. However, children with a medical history of childhood infections or more than one anatomic site had significantly greater risk of having a longer time to resolution.
Warts resolved in 65% of children by 2 years and in 80% within 4 years, regardless of treatment. With the exception of a history of childhood infections and having more than one anatomic site, time to resolution was not altered by wart or patient characteristics. Thus counseling without aggressive destructive treatment is a reasonable approach to managing warts in most children. Our findings will provide guidance in the process of shared decision making with parents and children.
目的是在门诊环境中调查儿童寻常疣的人口统计学特征及病程。
对单中心、大学附属儿科皮肤科门诊中临床诊断为疣的0至17岁儿童队列进行回顾性病历审查和电话调查研究。主要结局指标包括儿童疣的治疗、消退时间及相关因素。
在我们联系的254名患者中,214名同意参与调查。最常受累部位是手部以及头颈部区域。大多数儿童接受了某种形式的治疗,但尚不清楚任何形式的治疗是否改变了病程。然而,有儿童期感染病史或累及不止一个解剖部位的儿童,疣体消退时间明显更长的风险显著更高。
无论是否接受治疗,65%的儿童疣体在2年内消退,80%在4年内消退。除儿童期感染病史和累及不止一个解剖部位外,疣体消退时间不受疣体或患者特征的影响。因此,对于大多数儿童,不采取积极的破坏性治疗进行咨询是管理疣的合理方法。我们的研究结果将为与家长和儿童共同决策的过程提供指导。