Epidemiology and prescribed treatments in childhood psoriasis: A survey among medical professionals

Department of Dermatology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.
Journal of Dermatological Treatment (Impact Factor: 1.67). 02/2009; 20(5):254-8. DOI: 10.1080/09546630902911847
Source: PubMed


A study was conducted to explore the epidemiology of childhood psoriasis in general practitioners (GPs) and dermatological practice in the region of our academic medical centre. The treatments used by GPs and dermatologists in juvenile psoriasis were investigated.
A questionnaire was sent to 229 GPs and 73 dermatologists. Questions were addressed about the prevalence of childhood psoriasis and treatments used in this disease.
Seventy-three questionnaires were completed. The response rate was 17.0% for GPs and 46.6% for dermatologists. Almost one-third of all GPs have seen one or more patients with juvenile psoriasis under the age of 11 in their own patient population, in contrast to more than 80% of the dermatologists. Extrapolating the results implied an estimated prevalence of childhood psoriasis of 0.17% in the overall Dutch population. Topical corticosteroids were used by 46.2% of GPs and by 91.2% of dermatologists. Vitamin D analogues were prescribed by GPs and dermatologists in 15.4% and 73.5% of cases, respectively. Systemic medication for juvenile psoriasis was only used by 20.6% of dermatologists.
Calculated for the Dutch population, there should be approximately 27,500 children with psoriasis in The Netherlands. Topical corticosteroids were the first-choice treatment for both GPs and dermatologists, whereas vitamin D analogues were used as a second-choice topical therapy. Systemic medication was only sparsely prescribed by dermatologists.

1 Follower
8 Reads
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: There have been few studies done on the isolation and characterization of Chinese swamp buffalo embryonic germ cells (EG cells). Here, we first report on EG-like cells isolated from Chinese swamp buffalo fetuses. The results showed the cells grew in large, multilayered colonies, which were densely packed with an obvious border resembling mouse embryonic stem cells (ES cells) and EG cells. The buffalo EG-like cells expressed AP, SSEA-1, SSEA-3, SSEA-4 and OCT-4. By RT-PCR, we found that undifferentiated swamp buffalo EG-like cells expressed the OCT-4, NANOG, SOX2, FOXD3, GP130, STAT3, and HEB gene mRNA, but not Fgf4. When these cells were cultured for more than 2weeks without passage, they could differentiate into several types of cells including fibroblast-like, neuron-like, smooth muscle-like, and epithelial-like cells. Some cells formed simple embryoid bodies (EBs) and cystic EBs by suspension culture. By RT-PCR, we found cystic EBs expressed FOXD3, GP130, STAT3 and HEB gene mRNA, but not OCT-4, NANOG, and SOX2 gene mRNA, which could be detected in undifferentiated buffalo EG-like cells. At the same time, the expression of KERATIN-14 (Endoderm), GATA4, ACTA2 (Mesoderm) and TUBB3 (Ectoderm) gene mRNA were also detected in cystic EBs. The results suggested that these cells were capable of forming three germ layers in in vitro differentiation. The expression of OCT-4, NANOG and SOX2 might be essential for Chinese swamp buffalo EG-like cells in a pluripotent state. During the isolation and culture of Chinese swamp buffalo EG-like cells, we found the fetuses that were at 30-80days post-coitus were more efficient than others; and the mechanical method was better than trypsin digestion. The maximal passage of the mechanical method was eight, but the trypsin digestion was just three passages. So it seemed like that the buffalo EG-like cells were sensitive to trypsin. In summary, we were the first to isolate and characterize Chinese swamp buffalo EG-like cells that had morphology and characterization similar to those of established EG/EG-like cells in mouse and human.
    Cell Biology International 11/2007; 31(10):1079-88. DOI:10.1016/j.cellbi.2007.03.002 · 1.93 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: The literature review for 2009 covers the principal themes of the speciality and brings new findings in the fields of pathophysiology, clinical features, therapeutical approaches. With regards to atopic dermatitis, we noticed new studies on potential inducing factors (breastfeeding, probiotics, food, vitamins, prematurity, Staphylococcus aureus and constipation). There are also new data on therapy using tacrolimus. With regards to vascular anomalies and especially haemangiomas, the literature comprises new data on evolution and efficacy of propranolol. With regards to congenital nevi, there are studies related to treatment and complications. With regards to warts, the literature brings news about virus transmission and therapy. With regards to genodermatosis (neurofibromatosis type I, cutis laxa, pseudoxanthoma elasticum, epidermolysis bullosa, ichtyoses and pilar diseases), we found novel facts in the fields of molecular analysis, clinical aspects, pathophysiology and quality of life. The literature in 2009 also contains studies on Lyell syndrome, Kawasaki disease, vitiligo, psoriasis, pityriasis rubra pilaris, urticaria and alopecia areata.
    Annales de Dermatologie et de Vénéréologie 12/2009; 136. DOI:10.1016/S0151-9638(09)73384-8 · 0.92 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Juvenile psoriasis is a chronic and incurable skin disease that affects approximately 0·7% of children. To achieve more insight into the quality of life (QoL) in childhood psoriasis and to investigate whether disease severity scores correlate with QoL scores. All consecutive patients with juvenile plaque psoriasis (≤ 18 years old) who visited our outpatient department were included. At baseline, the Children's Dermatology Life Quality Index (CDLQI) questionnaire was completed and disease severity was assessed by the Psoriasis Area and Severity Index (PASI) and the Physician Global Assessment (PGA). Thirty-nine patients were included in the study. A median CDLQI of 6 [interquartile range (IQR) 5–9] was reported. Median PASI was 6·3 (IQR 3·3–8·2) and median PGA was 2 (IQR 1–3). The correlation coefficient between PASI and CDLQI was 0·47 (P = 0·003), whereas the correlation coefficient between PGA and CDLQI was 0·51 (P = 0·001). The negative effect on QoL in juvenile psoriasis was confirmed in the largest cohort presented up to now. The correlation between disease severity scores and disease-related QoL in children with psoriasis is only moderate. Therefore, both clinical outcome parameters (PASI, PGA) and measures of QoL (CDLQI) should be included in adequate, patient-oriented clinical decision making.
    British Journal of Dermatology 11/2010; 163(5):1099-101. DOI:10.1111/j.1365-2133.2010.09993.x · 4.28 Impact Factor
Show more

Similar Publications