| BackgroundPsoriasis is one of the common intractable skin diseases in dermatology department,which,as an inflammatory disease,is chronic and repetitiousrepetitive.Psoriasis can take place at any age,but obviously adults take majority of the psoriasis patients.Nowadays as for the rate of psoriasis happening in the children,no large-scale clinical researches domestic and overseas could explain how much the rate is,but some documents have proved that the rate was increasing over the years.The specific reasons of pediatric psoriasis are unknown,however,a number of literatures demonstrate that some factors participate in the course of psoriasis happening which include inheritance,infection,environment,endocrine,psychoneural aspect and psychic trauma,similar to the adults’.Clinically,pediatric psoriasis is able to be divided into four types including psoriasis vulgaris,psoriasis pustulosa,erythrodermic psoriasis and psoriasis arthropathica,clinical features,drugs and therapeutic effects in each type are not totally different mutually.As for the treatment category of pediatric psoriasis,a standard guide has not been drawn up until now at home and abroad,therefore,therapeutic schedules among different hospitals are maken mainly according to the related literatures and dermatologists or pediatrists’ treatment experience.The purpose of pediatric psoriasis treating is chiefly to control the disease,prolong the recrudescent time,decrease the recrudescent frequency,meanwhile,reducing the drug side effects as much as possible.Owing to the fewer relevant researches,thus further exploring the clinical features of pediatric psoriasis types is essential,and it is to the benefit of realizing pathogenesis as well as enhancing the ability of diagnosis and treatment of pediatric psoriasis.ObjectiveBy analyzing retrospectively the pediatric psoriasis cases collected who were hospitalized and treated in the Second Hospital of Jilin University dermatological department over the past 8 years,we try hard to summarize the pathogenic characteristics,clinical features,treatment strategies and therapeutic effects,and then enhance the understanding of each type of pediatric psoriasis,and sequentially better prevent and treat pediatric psoriasis.MethodInvestigate retrospectively the pediatric psoriasis cases collected and below 18 years old who were hospitalized and treated in the Second Hospital of Jilin University dermatological department during the time of Jan 2009 to Dec 2016,counting up to 73,list and register every patient’s age,gender,inducing factor,family medical history,first incidence time,first onset season,course of the disease,hospital stay,first pathogenic sites,implicative range,laboratory inspection,treatment strategy,clinical treatment effects and so on,then process the data using the statistical methods and acquire statistical results.At last analyze the results.Result1.There are 35 psoriasis vulgaris cases,25 psoriasis pustulosa cases and erythrodermic psoriasis cases,no psoriasis arthropathica case,and the ratio of the three types is 3.69:1.92:1.Thereinto male to female ratios in three types are respectively 1.92:1、3.17:1、2.5.The average age of psoriasis vulgaris,psoriasis pustulosa and erythrodermic psoriasis are respectively 12.17±4.56 years,11.46±4.46 years and 13.31±3.568 years,then it turns out that it has not significant differences among three types in the aspect of average age.Also in each type of pediatric psoriasis,there is no statistical significance at the aspect of the average age between men and women.2.The first incidence age of psoriasis vulgaris patients is for the range of 3-17 years,the average ages of first onset is 10.49±4.743 years,and the average ages of first onset in male and female patients are respectively 10.22±4.98 years,11.00±4.41 years.The first incidence age of psoriasis pustulosa is for the range of 1-17 years,the average ages of first onset is 8.96±5.029 years,and average ages of first onset in male and female patients are respectively 9.26±4.60 years,8.00±6.60 years.The first incidence age of erythrodermic psoriasis is for the range of 7-17 years,the average ages of first onset is 12.00±3.367 years,and average ages of first onset in male and female patients are respectively 13.00±3.082 years,9.75±3.202 years.After the independent sample t test,it proves that it has no significant difference between male and female within each type.After ANOVA test,we find that three types are no statistical significance in the aspect of the first incidence age.3.In psoriasis vulgaris cases,the number of patients with a positive family history is 8,accounting for 22.86% of psoriasis vulgaris patients.In psoriasis pustulosa cases,there are 5 persons with a positive family history,accounting for 20% of the psoriasis pustulosa patients.In erythrodermic psoriasis cases,te patients with a positive family history count up to 5,accouting for 38.46% of the erythrodermic psoriasis patients.There are 18 cases who have clear inducing factors in psoriasis vulgaris,thereinto infection cases occupying a proportion of 45.71%.There are 10 cases having a clear inducing factors in psoriasis pustulosa,patients with upper respiratory infection assuming a proportion of 20%.There are 7 cases having certain inducing factors in erythrodermic psoriasis,among them patients with upper respiratory infection accounting for 23.08%.4.About the first onset seasons of each type patients,it statistically turns out winter is mainly distributed,however,in spring and autumn season,it has similar morbidity among all types of pediatric psoriasis patients,beyond the morbidity in summer.5.In psoriasis vulgaris,the most common first pathogenic sites are scattered distribution among the body,trunk and four limbs are less common,bilateral knees and elbows are comparatively uncommon.In psoriasis pustulosa,the most common first pathogenic site is the trunk,less common successively legs,scattered distribution among the body,groin,perineum.In erythrodermic psoriasis,the most common first pathogenic site is the trunk.6.In psoriasis vulgaris cases,LDL-C level is remarkably below normal lower limit.In psoriasis pustulosa cases,WBC,NE,MO levels are obviously above the normal high limit,TP,Alb,LDL-C levels are dramatically below normal lower limit.In erythrodermic psoriasis cases,MO level is markedly above the normal high limit,TP,LDL-C levels are memorably below normal lower limit.7.In psoriasis vulgaris patients,the treatment time range is between the 3 days and 32 days,and average treatment time is 16.34±7.7 days,among them,13 cases totally cured,13 cases remarkedly effective,6 cases effective,3 cases noneffective.In psoriasis pustulosa patients,the treatment time range is between the 5 days and 50 days,and average treatment time is 22.92±12.072 days,among them,16 cases totally cured,5 cases remarkedly effective,4 cases effective.In erythrodermic psoriasis patients,the treatment time range is between the 10 days and 46 days,and average treatment time is 23.31±10.866 days,among them,6 cases totally cured,6 cases remarkedly effective,1 cases effective.Adopt rank sample test to compare the curative effect of the therapeutic schedules within the psoriasis vulgaris,the same disposition with psoriasis pustulosa and erythrodermic psoriasis.It is no statistical significance among the therapeutic schedules within each type.Conclusion1.In pediatric psoriasis,not only average age of patients in psoriasis vulgaris,psoriasis pustulosa and erythrodermic psoriasis exist no significant differences,but also the average age of patients between male and female within each type.In each type,the first incidence age between male and female uniformly has no obvious significance.Besides that,the first incidence age in each type also has no obvious significance.2.Heredity and infection take a higher proportion in the inducing factors of pediatric psoriasis.3.In regard to the first onset seasons of each type patients,it statistically turns out winter is mainly distributed,however,in spring and autumn season,it has similar morbidity among all types of pediatric psoriasis patients,beyond the morbidity in summer.4.The first pathogenic sites of each type psoriasis mostly exist on the trunk,and groin as well as perineum are commom first pathogenic sites in psoriasis pustulosa likewise.5.In psoriasis vulgaris cases,LDL-C level is remarkably below normal lower limit.In psoriasis pustulosa cases,WBC,NE,MO levels are obviously above the normal high limit,TP,Alb,LDL-C levels are dramatically below normal lower limit.In erythrodermic psoriasis cases,MO level is markedly above the normal high limit,TP,LDL-C levels are memorably below normal lower limit.6.The treatment time of patients in psoriasis vulgaris is shorter than that in psoriasis pustulosa and erythrodermic psoriasis,but the treatment time of patients between psoriasis pustulosa and erythrodermic psoriasis is no obvious difference.The therapeutic schedules among three types have no significant difference,in other words,these therapeutic schedules have similar treatment effects. |
PDF Full Text Request