Format

Send to

Choose Destination
Br J Dermatol. 2019 Feb 15. doi: 10.1111/bjd.17780. [Epub ahead of print]

Practice-Based Differences in Pediatric Discoid Lupus Erythematosus.

Author information

1
University of Wisconsin Madison, School of Medicine and Public Health, Department of Dermatology and Pediatrics, Madison, Wisconsin.
2
University of Wisconsin Madison, School of Medicine and Public Health, Department of Biostatistics, Madison, Wisconsin, United States.
3
Medical College of Wisconsin, Department of Dermatology and Pediatrics, Milwaukee, Wisconsin, United States.
4
University of Texas Southwestern Medical Center, Department of Dermatology, Dallas, Texas, United States.
5
University of Colorado, Department of Pediatrics, Denver, Colorado, United States.
6
Baylor College of Medicine, Department of Pediatrics and Dermatology, Houston, Texas, United States.
7
Northwestern University Feinberg School of Medicine, Department of Dermatology and Pediatrics, Chicago, Illinois, United States.
8
University of Pennsylvania Perelman School of Medicine, Department of Dermatology, Philadelphia, Pennsylvania, United States.
9
Corporal Michael J. Crescenz (Philadelphia) Veteran's, Administration Medical Center.
10
University of California San Francisco, Department of Pediatrics, San Francisco, California, United States.

Abstract

BACKGROUND:

Children with discoid lupus erythematosus (DLE) are at risk for disfigurement and progression to systemic lupus erythematosus (SLE). Consensus is lacking regarding optimal care of children with DLE.

OBJECTIVES:

We compared practice patterns among pediatric dermatologists/rheumatologists treating pediatric DLE.

METHODS:

An online survey was sent to 292 pediatric rheumatologists in the Childhood Arthritis & Rheumatology Research Alliance (CARRA) and 200 pediatric dermatologists in the Pediatric Dermatology Research Alliance (PeDRA). Consensus was defined as >70% agreement.

RESULTS:

Survey response rates were 38% (dermatology, n = 76/200) and 21% (rheumatology, n = 60/292). Both specialties agreed that screening labs should include complete blood counts with differential, urinalysis, complements, erythrocyte sedimentation rate, antinuclear antibody and other autoantibodies, hepatic function, and renal function/electrolytes. Both specialties agreed that arthritis or nephritis should prompt intensified evaluation for SLE. No other patient features achieved consensus as disease-modifying risk factors. Hydroxychloroquine was agreed upon as first-line systemic therapy, but consensus was lacking for second or third-line treatment.

CONCLUSIONS:

We found few areas of consensus and significant practice differences between pediatric dermatologists/rheumatologists treating DLE. Knowledge gaps include risk factors for SLE, optimal screening and treatment of refractory skin disease. This article is protected by copyright. All rights reserved.

PMID:
30768778
DOI:
10.1111/bjd.17780

Supplemental Content

Full text links

Icon for Wiley
Loading ...
Support Center