A systematic review of diagnostic criteria for psoriasis in adults and children: evidence from studies with a primary aim to develop or validate diagnostic criteria

Burden‐Teh, Esther; Phillips, Rebecca; Kim, Thomas; Ratib, Sonia; Grindlay, D. J. C.; Murphy, Ruth

doi:10.1111/bjd.16104

Cited by 15 publications

(16 citation statements)

References 53 publications

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“…Our PIA cohort offers the opportunity to assess the course and clinical phenotype of adolescent psoriasis in a general population. The diagnosis of psoriasis has been confirmed clinically, and even though no recognised clinical examination-based criteria on paediatric psoriasis exist we supported our diagnosis by a predefined set of criteria 12. We have data on possible trigger factors for psoriasis and medical history regarding a range of other diseases and known comorbidities.…”

Section: Findings To Datementioning

confidence: 67%

“…The diagnosis of psoriasis is mostly clinical and based on skin appearance, although a skin biopsy supports the diagnosis. In children and adolescents, psoriasis can be difficult to diagnose because of mild and overlapping symptoms (eg, atopic and seborrheic dermatitis) and a lack of validated clinical examination-based diagnostic criteria 3 12–14. The most common type of psoriasis, plaque psoriasis, manifests itself as well-demarcated red and scaly plaques, with itch and discomfort as common complaints 15.…”

Section: Introductionmentioning

confidence: 99%

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Cohort profile: the clinical ‘Psoriasis in Adolescents’ (PIA) cohort in Denmark

et al. 2019

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PurposePsoriasis is a chronic inflammatory skin disease that frequently debuts in childhood and adolescence. We wished to determine environmental and genetic risk factors for the development of psoriasis in children and adolescents, as well as to investigate debut type, trigger factors, course of disease, nature and influence of stress related to both child and family and risk factors for comorbidity. The ‘Psoriasis in Adolescents’ (PIA) cohort will provide data on the relationship between psoriasis and, respectively, genetic disposition, early-life exposures, quality of life and comorbidity.ParticipantsThe PIA cohort is nested in the large general population Danish National Birth Cohort (DNBC). We invited 390 adolescents with psoriasis and corresponding maternally predisposed and non-predisposed controls. Participants underwent an interview and a clinical examination consisting of a skin inspection and physical measurements including blood sampling and microbiological swabs. Additionally, four self-administered questionnaires on physical and mental health were completed.Findings to dateThe final PIA cohort consists of 81 adolescents with psoriasis, 110 parentally predisposed and 124 non-predisposed psoriasis-free adolescents. The validity of the maternally reported psoriasis status from the DNBC was found to be low on clinical examination (47.5%). In contrast, the self-reported psoriasis status of the DNBC mothers was clinically confirmed in 80.8% of the cases.Future plansThe PIA cohort offers the possibility of assessing the clinical characteristics, course of psoriasis and development of comorbidities in adolescents with clinically confirmed disease from a general population. Comparison with predisposed and non-predisposed controls is possible and genetic analyses are scheduled. We plan to invite the participants for a follow-up in 5–10 years. Furthermore, we plan to include newly diagnosed adolescents with psoriasis from the 18-year DNBC follow-up. All information is linkable on the individual level with data from the DNBC and nationwide registries in Denmark.

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Section: Findings To Datementioning

confidence: 67%

Section: Introductionmentioning

confidence: 99%

Cohort profile: the clinical ‘Psoriasis in Adolescents’ (PIA) cohort in Denmark

et al. 2019

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“…Poor recognition and delayed diagnosis of psoriasis in children can lead to inadequate treatment and lack of monitoring for comorbidities including juvenile psoriatic arthritis . Diagnostic criteria would help both clinical practice and clinical research, but to date there are none available . The aim of this study was to agree a list of expert‐derived diagnostic criteria for plaque psoriasis in children using electronic Delphi (eDelphi) consensus methodology.…”

Section: The Results Of Round 2 and Round 3 Of The Edelphi Consensus mentioning

confidence: 99%

Development of clinical diagnostic criteria for plaque psoriasis in children: an electronic Delphi consensus study with the International Psoriasis Council

et al. 2019

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“…[56] It is also possible that there is diagnostic confusion from the individuals’ point of view (such as confusing the term ‘psoriasis’ with ‘eczema’, which we have seen in clinical practice) or poor communication between the health care provider and the patient due to ambiguous diagnostic criteria. [57] We would therefore recommend that researchers using self-report to diagnose psoriasis should be aware that a substantial percentage of cases may go unidentified.…”

Section: Discussionmentioning

confidence: 99%

Accuracy of self-reported history of autoimmune disease: A pilot study

et al. 2019

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Research associating the increased prevalence of familial autoimmunity with neuropsychiatric disorders is reliant upon the ascertainment of history of autoimmune diseases from relatives. To characterize the accuracy of self-report, we compared self-reported diagnoses of 18 autoimmune diseases using an online self-report questionnaire to the electronic medical record (EMR) diagnoses in 1,013 adult (age 18–70 years) patients of a primary care clinic. For the 11 diseases meeting our threshold observed prevalence, we estimated sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for self-reported diagnoses under the assumption that EMR-based diagnoses were accurate. Six diseases out of 11 had either sensitivity or PPV below 50%, with the lowest PPV for dermatological and endocrinological diseases. Common errors included incorrectly self-reporting type 2 diabetes mellitus (DM), when type 1 DM was indicated by the EMR, and reporting rheumatoid arthritis when osteoarthritis was indicated by the EMR. Results suggest that ascertainment of familial autoimmunity through self-report contributes to inconsistencies and inaccuracies in studies of autoimmune disease history and that future studies would benefit from incorporating EMR review and biological measures.

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A systematic review of diagnostic criteria for psoriasis in adults and children: evidence from studies with a primary aim to develop or validate diagnostic criteria

Abstract: Clinical examination-based diagnostic criteria are currently lacking for psoriasis. Future research could follow an international collaborative approach and employ study designs allowing high-quality diagnostic accuracy testing. Existing and newly developed criteria require validation.

Cited by 15 publications

References 53 publications

Cohort profile: the clinical ‘Psoriasis in Adolescents’ (PIA) cohort in Denmark

Cohort profile: the clinical ‘Psoriasis in Adolescents’ (PIA) cohort in Denmark

Development of clinical diagnostic criteria for plaque psoriasis in children: an electronic Delphi consensus study with the International Psoriasis Council

Accuracy of self-reported history of autoimmune disease: A pilot study

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