Background and Objectives:

Psoriasis (Pso) in children may be confused clinically with atopic dermatitis (AD) and, indeed, the two conditions may co-exist. The aim of this study was to determine historical and clinical features that are different in paediatric Pso and AD and to describe children who have features of both: psoriasis-dermatitis overlap (PD).

研究背景和目的：

临床上，小儿银屑病（Pso）可能跟特应性皮炎（AD）混淆，并且实际上这两种皮肤病可能并存。本研究旨在确定儿童Pso和AD的病史以及临床特征的差异性，同时对含有这两种皮肤病（银屑病-皮炎重叠症）特征的患儿进行描述。

Methods:

Children with features of psoriasis or eczema, or both, who were referred to paediatric outpatients and/or private rooms were evaluated. Data were collected from 170 consecutive children aged less than 12 years between July 2011 and November 2011. Participants were classified by described criteria as having Pso (n = 64), AD (n = 62) or PD (n = 44).

研究方法：

对到儿科门诊和/或私人诊室就诊的银屑病或湿疹，或两病共患的临床特征患儿进行评定。在2011年7月到11月之间，收集170名不超过12岁的连续性患儿的资料。通过根据患有Pso (n = 64), AD (n = 62) or PD (n = 44)的描述标准对患儿进行分类。

Results:

Only 9.4% of children with Pso were correctly diagnosed by the referring doctor. Children with Pso relative to AD were more likely to have had a history of scaly scalp and nappy rash in infancy, a family history of psoriasis,current scalp and periauricular rashes, defined, patchy plaque morphology and papulosquamous rashes not typical of adult psoriasis on extensor elbows and knees. Children with PD had features of both but presented most often as typical paediatric psoriasis combined with flexural eczema. Children with Pso and PD responded well to specific treatment strategies for psoriasis, including potent topical corticosteroids (TCS), calcipotriol and phototherapy. Both Pso and PD tended to require more potent TCS than AD to achieve disease suppression.

研究结果：

仅9.4% 的Pso患儿，其主诊医生诊断正确。与AD相关的Pso患儿在婴儿时期更多的有头皮鳞屑和尿布疹病史、银屑病家族史，以及当前的头皮和耳部皮疹，界限清楚的片状斑块和丘疹鳞屑性皮疹而无成人肘部伸侧和膝部银屑病的典型特征。PD患儿含有以上两种疾病的特征，但是最常表现为典型小儿银屑病伴屈侧部位的湿疹。通过银屑病的特定治疗措施，包括强效外用皮质类固醇（TCS）、卡泊三醇治疗和光疗，Pso和PD患儿都有良好的效果。为了达到抑制疾病的效果，Pso和PD患儿比AD患儿趋向于需要更强效的TCS。

Conclusion:

We found that Pso and PD in children both differ clinically from AD and have identified historical and clinical features that characterise childhood Pso.

结论：

我们发现儿童Pso和PD均不同于AD，并且确定了儿童Pso的病史和临床特征。