Demirkan Fatma Gul, Topkarci Zeynep, Karadag Serife Gul, Sonmez Hafize Emine, Cakmak Figen, Ayaz Nuray Aktay
Department of Pediatric Rheumatology, University of Health Sciences, Kanuni Sultan Suleyman Training and Research Hospital, Istanbul, Turkey.
Department of Dermatology, Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey.
North Clin Istanb. 2020 Nov 20;8(1):37-41. doi: 10.14744/nci.2020.32848. eCollection 2021.
Dermatological findings may be the sole complaints of diseases in pediatric rheumatology practice. Evaluating patients with a multi-disciplinary approach may facilitate access to an accurate diagnosis. Herein, we reported our one-year experience in collaborative pediatric rheumatology-dermatology.
Patients were initially evaluated separately in pediatric rheumatology-dermatology outpatient clinics. Subsequently, once a week, the final diagnoses of patients with suspected skin rash were collaboratively discussed by two pediatric rheumatologists and a dermatologist.
A hundred and one patients were included in this study. Of these 101 patients, 65 attended to dermatology outpatient clinic initially, while the remaining 36 applied to the pediatric rheumatology outpatient clinic. The most common mucocutaneous finding was squamous lesions in 30 patients, followed by erythematous lesions in 28 and mucosal ulcers in 14. Finally, 69 patients were diagnosed with a rheumatic disease while 32 had differential diagnoses apart from rheumatic diseases.
Patients with rheumatologic diseases frequently present with only mucocutaneous findings. Thus, a detailed examination of the mucosa, skin and its attachments is of paramount importance in rheumatology practice. We suggest that a close interaction between pediatric rheumatology-dermatology and the formation of consensus clinics are going to assist clinicians in making easier and accurate diagnoses.
在儿科风湿病诊疗实践中，皮肤表现可能是疾病的唯一主诉。采用多学科方法评估患者可能有助于获得准确诊断。在此，我们报告了我们在儿科风湿病与皮肤科协作方面的一年经验。
患者最初在儿科风湿病和皮肤科门诊分别接受评估。随后，每周一次，由两名儿科风湿病医生和一名皮肤科医生共同讨论疑似皮疹患者的最终诊断。
本研究纳入了101例患者。在这101例患者中，65例最初就诊于皮肤科门诊，其余36例就诊于儿科风湿病门诊。最常见的黏膜皮肤表现为30例患者出现鳞状病变，其次是28例红斑性病变和14例黏膜溃疡。最终，69例患者被诊断为风湿性疾病，32例有风湿性疾病以外的鉴别诊断。
风湿性疾病患者常仅表现为黏膜皮肤症状。因此，在风湿病诊疗实践中，对黏膜、皮肤及其附属器进行详细检查至关重要。我们建议儿科风湿病与皮肤科之间密切互动并形成共识门诊，这将有助于临床医生更轻松、准确地做出诊断。
