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Practice-based differences in paediatric discoid lupus erythematosus.

L M Arkin1, K Buhr2, H Brandling-Bennett1

  • 1Department of Dermatology and Pediatrics, University of Wisconsin Madison School of Medicine and Public Health, Madison, WI, U.S.A.

The British Journal of Dermatology
|February 16, 2019
PubMed
Summary
This summary is machine-generated.

Pediatric dermatologists and rheumatologists show significant differences in treating childhood discoid lupus erythematosus (DLE). There is a lack of consensus on optimal screening and treatment for DLE, impacting patient care.

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Area of Science:

  • Pediatric Rheumatology
  • Pediatric Dermatology
  • Autoimmune Diseases

Background:

  • Childhood discoid lupus erythematosus (DLE) poses risks of disfigurement and progression to systemic lupus erythematosus (SLE).
  • Optimal management strategies for pediatric DLE lack established consensus.
  • Understanding current practice patterns is crucial for improving care.

Purpose of the Study:

  • To compare the clinical practice patterns of pediatric dermatologists and rheumatologists managing pediatric DLE.
  • To identify areas of consensus and divergence in the treatment approaches for pediatric DLE.

Main Methods:

  • An online survey was distributed to pediatric rheumatologists (n=292) and dermatologists (n=200).
  • Consensus was defined as agreement among at least 70% of respondents.
  • Response rates were 38% for dermatology and 21% for rheumatology.

Main Results:

  • Both specialties agreed on essential screening laboratory tests, including CBC, urinalysis, complement levels, ESR, autoantibodies, and liver/renal function tests.
  • Agreement was reached that arthritis or nephritis warrants intensified SLE evaluation.
  • Consensus was achieved for hydroxychloroquine as first-line therapy, but not for subsequent treatment lines.

Conclusions:

  • Significant practice variations exist between pediatric dermatologists and rheumatologists in managing DLE.
  • Key knowledge gaps were identified concerning SLE risk factors, optimal screening protocols, and treatment for refractory skin disease.
  • Further research and guideline development are needed to standardize pediatric DLE care.