Pediatric Pustular Psoriasis in Southern China: A 12-Year Retrospective Analysis of 41 Cases Focusing on Clinical Characteristics and Treatment Outcomes.
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Abstract
Background: Pustular psoriasis (PP) is a systemic inflammatory disease that rarely occurs in children but adversely affects their quality of life.
Objective: This study aimed to evaluate the clinical characteristics, treatment, prognosis, and epidemiology of PP in pediatrics.
Methods: A single center retrospective study on 41 children diagnosed with PP was conducted in a university-affiliated referral hospital between January 2010 and May 2022. The demographics, clinical characteristics, treatment, and prognosis were evaluated in the descriptive analysis. To further investigate the effect of different acitretin-based treatments on the prognosis, 38 patients were included in the subgroup analysis. Patients who received acitretin alone were designated as the Acitretin group, while those who received acitretin combined with intravenous immunoglobulin, ciclosporin, or steroids (or any combination of these agents) were identified as the Combination group.
Results: A total of 41 patients were enrolled in the descriptive analysis. Of these, 65.8% (27/41) were male, and the mean age of onset was 3.2 ± 3.2 years. Among the patients, 63.4% (26/41) presented with pustules, and over half experienced fever and elevated C-reactive protein (CRP) levels. In the subgroup analysis, the CRP level was significantly higher in the Combination group (59.69 ± 43.74 versus 26.35 ± 19.67 mg/dL, P = 0.006), indicating that patients had more severe inflammatory conditions. Nevertheless, there was no significant difference in the remission rate between the Acitretin group and the Combination group.
Conclusion: Pediatric PP is a disease that often occurs in the pre-school period and predominantly affects males. It is characterized by typical skin lesions and systemic inflammatory reactions. Common comorbidities include nutritional disorders such as malnutrition and anemia. Combination treatment based on acitretin is recommended for children with PP and severe inflammation.
背景：脓疱性牛皮癣（PP）是一种全身性炎症性疾病，很少发生在儿童身上，但对他们的生活质量有不利影响。目的：探讨小儿PP的临床特点、治疗、预后及流行病学。方法：对2010年1月至2022年5月在某大学附属转诊医院诊断为PP的41例患儿进行单中心回顾性研究。在描述性分析中对人口统计学、临床特征、治疗和预后进行评估。为进一步探讨以阿曲维甲酸为基础的不同治疗方法对预后的影响，将38例患者纳入亚组分析。单独接受阿维甲素的患者被指定为阿维甲素组，而接受阿维甲素联合静脉注射免疫球蛋白、环孢素或类固醇（或这些药物的任何组合）的患者被确定为联合组。结果：共有41例患者入组描述性分析。其中男性占65.8%(27/41)，平均发病年龄为3.2±3.2岁。63.4%（26/41）的患者出现脓疱，超过一半的患者出现发烧和c反应蛋白（CRP）水平升高。在亚组分析中，联合治疗组CRP水平明显高于对照组（59.69±43.74 vs 26.35±19.67 mg/dL, P = 0.006），表明患者炎症情况更为严重。然而，阿维素组和联合组在缓解率上没有显著差异。结论：小儿PP是一种常见于学龄前且以男性为主的疾病。它的特点是典型的皮肤病变和全身炎症反应。常见的合并症包括营养失调，如营养不良和贫血。对于患有PP和严重炎症的儿童，推荐以阿维a为基础的联合治疗。
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