儿童环状肉芽肿的临床表现和治疗：系统评价。

Clinical Manifestations and Management of Pediatric Granuloma Annulare: A Systematic Review.

机构信息

Department of Dermatology and Reference Center for Rare Diseases and Vascular Malformations (MAGEC), CHRU Tours, Tours, France; Unit of Pediatric Dermatology, CHRU Tours, Tours, France.

Department of Dermatology and Reference Center for Rare Diseases and Vascular Malformations (MAGEC), CHRU Tours, Tours, France; Unit of Pediatric Dermatology, CHRU Tours, Tours, France; Universities of Tours and Nantes, INSERM 1246-SPHERE, Tours, France.

出版信息

J Pediatr. 2023 Jun;257:113392. doi: 10.1016/j.jpeds.2023.03.006. Epub 2023 Mar 21.

DOI:10.1016/j.jpeds.2023.03.006

PMID:36948386

Abstract

OBJECTIVE

To determine the clinical manifestations, management, and outcomes of pediatric granuloma annulare (GA).

STUDY DESIGN

We searched MEDLINE via PubMed, Latin American and Caribbean Health Sciences, and EMBASE from inception to January 2021. We included all original reports of patients <18 years of age with a diagnosis of GA and all original reports describing any intervention, including topical or systemic agents, in these patients. Two authors independently extracted sociodemographics and clinical data of the study patients and treatment(s) used.

RESULTS

Of 2440 reports screened, 202 were included (836 patients). The mean age was 5.7 (SD 3.8) years and F:M ratio 1.3:1. Localized GA (n = 384/821, 46.8%) and subcutaneous GA (n = 353/821, 43.0%) were the most prevalent subtypes. The most affected site was lower limbs (n = 272/568, 47.9%). Suspected triggering factors were mainly local trauma. Diabetes was associated in 22 (2.6%) patients. The rate of spontaneous remission was high (n = 140/155, 90.3%), with a median time of 12 months. The most frequent therapies were surgery and topical corticosteroids. Recurrence was observed in 38.3% (n = 168/439) of patients, regardless of treatment.

CONCLUSIONS

Pediatric GA frequently resolves spontaneously yet displays a high recurrence rate. Hence, in asymptomatic forms, invasive therapies are not recommended as first-line treatment.

摘要

目的

确定儿童环状肉芽肿（GA）的临床表现、治疗方法和结局。

研究设计

我们通过 PubMed 中的 MEDLINE、拉丁美洲和加勒比健康科学数据库以及 EMBASE 进行了检索，检索时间从建库至 2021 年 1 月。我们纳入了所有<18 岁、诊断为 GA 的患者的原始报告，以及描述这些患者使用任何干预措施（包括局部或全身药物）的原始报告。两名作者独立提取了研究患者的社会人口统计学和临床数据以及使用的治疗方法。

结果

在筛选的 2440 篇报告中，有 202 篇符合纳入标准（821 例患者）。平均年龄为 5.7（标准差 3.8）岁，男女比例为 1.3:1。局限性 GA（n=384/821，46.8%）和皮下 GA（n=353/821，43.0%）是最常见的亚型。最常受累的部位是下肢（n=272/568，47.9%）。疑似诱发因素主要为局部创伤。22 例（2.6%）患者合并糖尿病。自发缓解率高（n=140/155，90.3%），中位时间为 12 个月。最常用的治疗方法是手术和局部皮质类固醇。439 例患者中有 38.3%（n=168）无论治疗与否均出现复发。