Naslov
A girl with annular scaly erythematous lesions

Autori
Delaš Aždajić, Marija ; Šitum, Mirna ; Dediol, Iva

Vrsta, podvrsta i kategorija rada
Sažeci sa skupova, sažetak, stručni

Skup
3. Konferencija o palijativnoj skrbi s međunarodnim sudjelovanjem: “Palijativna skrb u zajednici – hrvatska i europska iskustva“

Mjesto i datum
Pula, Hrvatska, 04.10.2018. - 07.10.2018

Vrsta sudjelovanja
Poster

Vrsta recenzije
Recenziran

Ključne riječi
psoriasis ; chronic inflammatory skin disease

Sažetak
Psoriasis is a common chronic inflammatory skin disease, affecting up to 2% of the pediatric population. The prevalence of psoriasis in children is lower than in adults, but the significant number of adults who first developed skin disease in childhood supports the frequent persistence of psoriasis into adulthood. The effect of psoriasis on social interaction can be avoided with early diagnosis, continuous follow up and effective therapeutic intervention. Sometimes clinical picture of pediatric psoriasis is atypical in comparison to adult psoriasis, and could manifest in association with atopic dermatitis. This is the reason it is possibly misdiagnosed and under recognized. The differential diagnosis of psoriasis in young children includes atopic dermatitis, seborrheic dermatitis, nummular dermatitis, pityriasis rubra pilaris and tinea corporis. A 8-year old girl presented to the clinic for initial evaluation of multiple lesions on trunk and face, present for 2 years, sometimes combined with mild pruritus and with clinical regression of symptoms during summer period. Examination revealed moderately severe psoriasiform annular plaques distributed in scalp, on the upper arms, elbows, knees, and back. Personal and family history were not significant. A clinical diagnosis of allergic contact dermatitis (ACD) was suspected ; laboratory testing and skin biopsy were subsequently performed. Histopathological analysis showed epidermal parakeratosis and mild perivascular mononuclear infiltration around follicules’openings localized in superficial dermis, which confirmed the diagnosis of nummular dermatitis. ANA were positive 1:640, C-reactive protein 7, rheumatoid factor <20 and total IgE 36. Repeated skin biopsy was planned, but the patient refused. However, due the clinical picture, topical corticosteroids and keratolytics combined with phototherapy UVB TLO1 were included in the therapy, with good regression of the lesions. Sometimes histological findings do not correspond with clinical diagnosis, especially in younger patients. In view of the likely common occurrence and chronic nature of disease, an early recognition and a subsequent appropriate approach may delay or even prevent considerable impact on children’s quality of life or some co-morbidities.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti

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