Management of Paediatric Psoriasis by Paediatricians: A Questionnaire-Based Survey
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ORIGINAL RESEARCH
Management of Paediatric Psoriasis by Paediatricians: A Questionnaire-Based Survey Andreas Pinter
. Nicole Mielke . Bartosz Malisiewicz .
¨ nig Roland Kaufmann . Anke Ko
Received: March 31, 2020 Ó The Author(s) 2020
ABSTRACT Introduction: Paediatric plaque psoriasis (PedPso) in children and adolescents is often diagnosed and treated for the first time by paediatricians. An early onset of psoriasis is associated with a genetic family burden, higher severity of disease and increased risk of comorbidities, sometimes starting in childhood. However, little information is available on prevalence data and the clinical management of PedPso by paediatricians. Methods: A total of 191 questionnaires were sent out to paediatricians regarding their management of PedPso, with a focus on prevalence, diagnosis, initiation of therapies, screening for comorbidities and collaboration with dermatologists. Of these, 95 (49.7%) were returned and evaluated anonymously.
Digital Features To view digital features for this article go to https://doi.org/10.6084/m9.figshare.12213752. Electronic supplementary material The online version of this article (https://doi.org/10.1007/s13555020-00390-y) contains supplementary material, which is available to authorized users. A. Pinter (&) N. Mielke B. Malisiewicz ¨ nig R. Kaufmann A. Ko Department of Dermatology, Venereology and Allergology, University Hospital Frankfurt am Main, Frankfurt am Main, Germany e-mail: [email protected]
Results: Only about one-half of the responding paediatricians reported being certain in their diagnosis of PedPso, even though they regularly see moderate-to-severely affected patients. The questionnaire revealed that there are clear differences in the general management of PedPso if the paediatrician is not certain of the diagnosis of psoriasis. Compared to paediatricians certain of their diagnosis, those who are uncertain less frequently perform whole-body inspection, screen for relevant comorbidities, such as psoriasis arthritis, metabolic syndrome or mental disorders, and prescribe the use of topical or systemic therapies. No responding paediatrician reported the use of modern systemic therapies, such as biologicals, even in severely affected children. The majority of respondents rated their cooperation with dermatologists as good. Conclusion: The certainty of the diagnosis, the use of system therapies and the screening for comorbidity could improve the care of PedPso through targeted training of paediatricians and intensified interdisciplinary cooperation with dermatologist. Keywords: Adolescent; Childhood; Juvenile; Management; Paediatric; Paediatrician; Psoriasis; Therapy; Treatment
Dermatol Ther (Heidelb)
Key Summary Points Little is known about how paediatricians routinely diagnose and treat juvenile patients with psoriasis in the clinical setting, even though many children with skin diseases are managed by paediatricians. An anonymous survey was sent out to paediatricians to investigate the degree of certainty with the diagno
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