Qing Min, Liu Panpan, Zhu Wu, Chen Menglin, Chen Mingliang, Kuang Yehong
Department of Dermatology, Xiangya Hospital, Central South University, Changsha 410008, China.
Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2020 Jul 28;45(7):804-811. doi: 10.11817/j.issn.1672-7347.2020.190129.
Psoriasis is a chronic inflammatory skin disease that affects adults and children. The most common subtype is psoriasis vulgaris. This article analyzes the characteristics and clinical features of children with psoriasis vulgaris to strengthen the understanding, treatment, and management for children with psoriasis.
A total of 208 children with psoriasis vulgaris, who were first admitted to the Department of Dermatology, Xiangya Hospital, Central South University from October 2012 to December 2018, were retrospectively analyzed. Their clinical characteristics, results of laboratory examination, treatment options and efficacy were summarized.
The age of the 208 children with psoriasis vulgaris was (11.19±3.97) years old, the peak incidence was 12 years old, the disease duration was (27.46±31.30) months, and the male-female ratio was 1∶0.96. The most common site of the first attack was the scalp (37.98%), followed by the trunk (26.44%) and the limbs (22.12%). The causes leading to exacerbation were more common in infections and diets. There were 33 patients (15.87%) with a family history of psoriasis, showing the higher score of Psoriasis Area and Severity Index (PASI) and the higher Dermatological Quality of Life Index (DLQI) (both <0.05). In all patients, 29 cases (13.94%) were overweight, 19 cases (9.14%) were obese, and the rate of overweight and obesity in children with psoriasis vulgaris was higher than that of normal children in China. In the laboratory test, the serum levels of 25-hydroxyvitamin D (25-OH-VD) were decreased in most patients (47.5%), and the serum 25-OH-VD levels were found to be moderately negatively correlated with PASI score (<0.05). The score of DLQI in the patient was 5.56±3.57, the score of PASI was 7.25±6.83, and they were positively correlated (=0.409, <0.001). In most patients (72.11%), the severity of the disease was mild to moderate. Their treatment was often dominated by topical drugs and Chinese patent medicine (65.67%). Retinoids showed a good effect on children. Cyclosporine and methotrexate were effective in more severe cases.
Children with psoriasis vulgaris are mainly caused by infection and diet. Patients with family history have more serious illness, lower quality of life, and are more likely to have metabolic abnormalities such as overweight and obesity. The serum 25-OH-VD levels in children with psoriasis vulgaris are negatively correlated with the score of PASI.
银屑病是一种影响成人和儿童的慢性炎症性皮肤病。最常见的亚型是寻常型银屑病。本文分析寻常型银屑病患儿的特点和临床特征，以加强对银屑病患儿的认识、治疗及管理。
回顾性分析2012年10月至2018年12月首次入住中南大学湘雅医院皮肤科的208例寻常型银屑病患儿。总结其临床特征、实验室检查结果、治疗方案及疗效。
208例寻常型银屑病患儿年龄为（11.19±3.97）岁，发病高峰年龄为12岁，病程为（27.46±31.30）个月，男女比例为1∶0.96。首发最常见部位为头皮（37.98%），其次为躯干（26.44%）和四肢（22.12%）。导致病情加重的原因以感染和饮食较为常见。有33例（15.87%）患儿有银屑病家族史，其银屑病面积和严重程度指数（PASI）评分及皮肤病生活质量指数（DLQI）较高（均P<0.05）。所有患儿中，29例（13.94%）超重，19例（9.14%）肥胖，寻常型银屑病患儿超重和肥胖发生率高于我国正常儿童。实验室检查中，多数患儿（47.5%）血清25-羟维生素D（25-OH-VD）水平降低，血清25-OH-VD水平与PASI评分呈中度负相关（P<0.05）。患儿DLQI评分为5.56±3.57，PASI评分为7.25±6.83，二者呈正相关（r=0.409，P<0.001）。多数患儿（72.11%）病情为轻至中度。其治疗常以外用药物和中成药为主（65.67%）。维甲酸类药物对患儿疗效较好。环孢素和甲氨蝶呤对病情较重者有效。
寻常型银屑病患儿主要由感染和饮食引起。有家族史的患儿病情更严重，生活质量更低，且更易出现超重和肥胖等代谢异常。寻常型银屑病患儿血清25-OH-VD水平与PASI评分呈负相关。
