The term ‘lupus’ refers to a range of related disorders. Discoid lupus erythematosus (DLE) is a form of lupus in the skin, which is rare in children. It can lead to disfiguring scarring. Some patients develop systemic lupus (SLE), a type of lupus that affects the whole body, which can lead to damage to multiple organs. Small studies have suggested that 25 to 30% of children with DLE develop SLE over time, but risk factors for this are not known. Early diagnosis and treatment of SLE are helpful. This study used a survey approach to compare practice patterns between two medical specialties, academic rheumatologists and dermatologists, in the United States and Canada, caring for children with DLE. The study aimed to identify areas of agreement but also practice-based differences between groups. Consensus (agreement) occurred when 70% or more of both specialties agreed. The authors found consensus that certain laboratory studies should be checked for all children at diagnosis of DLE. Both groups agreed that the presence of “other auto-antibodies besides ANA”, arthritis, or nephritis were high-risk features for SLE that should increase screening for systemic disease. There were no other agreed-upon risk factors for SLE, including those that have previously been shown in adults with DLE. Both groups agreed that first-line systemic therapy (whole body treatment) for widespread DLE should be hydroxychloroquine. The authors could not agree on which medications to use for resistant skin disease. Overall, the study found some areas of agreement but many areas of practice-based difference. More data in children with DLE is necessary to determine best practice approaches. The authors are completing a type of study called a retrospective cohort study that may help to fill these gaps.
原文链接
分享
引用
