Practice-based differences in paediatric discoid lupus erythematosus

L. M. Arkin*, K. Buhr, H. Brandling-Bennett, Y. Chiu, B. Chong, M. Curran, R. Hunt, Amy Paller, V. P. Werth, Marisa S Klein-Gitelman, E. von Scheven, Kaveh Ardalan

*Corresponding author for this work

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Background: Children with discoid lupus erythematosus (DLE) are at risk for disfigurement and progression to systemic lupus erythematosus (SLE). Consensus is lacking regarding optimal care for children with DLE. Objectives: The aim of this study was to compare practice patterns among paediatric dermatologists/rheumatologists treating paediatric DLE. Methods: An online survey was sent to 292 paediatric rheumatologists in the Childhood Arthritis and Rheumatology Research Alliance and 200 paediatric dermatologists in the Pediatric Dermatology Research Alliance. Consensus was defined as ≥ 70% agreement. Results: Survey response rates were 38% (76 of 200) for dermatology and 21% (60 of 292) for rheumatology. Both specialties agreed that screening labs should include complete blood counts with differential, urinalysis, complement levels, erythrocyte sedimentation rate, antinuclear antibody and other autoantibodies, hepatic function and renal function/electrolytes. Both specialties agreed that arthritis or nephritis should prompt intensified evaluation for SLE. No other patient features achieved consensus as disease-modifying risk factors. Hydroxychloroquine was agreed upon as first-line systemic therapy, but consensus was lacking for second- or third-line treatment. Conclusions: We found few areas of consensus and significant practice differences between paediatric dermatologists and rheumatologists treating DLE. Knowledge gaps include risk factors for SLE, optimal screening and treatment of refractory skin disease.

Original languageEnglish (US)
JournalBritish Journal of Dermatology
DOIs
StatePublished - Jan 1 2019

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Discoid Lupus Erythematosus
Pediatrics
Systemic Lupus Erythematosus
Rheumatology
Dermatology
Arthritis
Hydroxychloroquine
Urinalysis
Blood Cell Count
Nephritis
Antinuclear Antibodies
Blood Sedimentation
Child Care
Research
Skin Diseases
Autoantibodies
Electrolytes
Therapeutics
Kidney
Liver

ASJC Scopus subject areas

  • Dermatology

Cite this

Arkin, L. M. ; Buhr, K. ; Brandling-Bennett, H. ; Chiu, Y. ; Chong, B. ; Curran, M. ; Hunt, R. ; Paller, Amy ; Werth, V. P. ; Klein-Gitelman, Marisa S ; von Scheven, E. ; Ardalan, Kaveh. / Practice-based differences in paediatric discoid lupus erythematosus. In: British Journal of Dermatology. 2019.
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title = "Practice-based differences in paediatric discoid lupus erythematosus",
abstract = "Background: Children with discoid lupus erythematosus (DLE) are at risk for disfigurement and progression to systemic lupus erythematosus (SLE). Consensus is lacking regarding optimal care for children with DLE. Objectives: The aim of this study was to compare practice patterns among paediatric dermatologists/rheumatologists treating paediatric DLE. Methods: An online survey was sent to 292 paediatric rheumatologists in the Childhood Arthritis and Rheumatology Research Alliance and 200 paediatric dermatologists in the Pediatric Dermatology Research Alliance. Consensus was defined as ≥ 70{\%} agreement. Results: Survey response rates were 38{\%} (76 of 200) for dermatology and 21{\%} (60 of 292) for rheumatology. Both specialties agreed that screening labs should include complete blood counts with differential, urinalysis, complement levels, erythrocyte sedimentation rate, antinuclear antibody and other autoantibodies, hepatic function and renal function/electrolytes. Both specialties agreed that arthritis or nephritis should prompt intensified evaluation for SLE. No other patient features achieved consensus as disease-modifying risk factors. Hydroxychloroquine was agreed upon as first-line systemic therapy, but consensus was lacking for second- or third-line treatment. Conclusions: We found few areas of consensus and significant practice differences between paediatric dermatologists and rheumatologists treating DLE. Knowledge gaps include risk factors for SLE, optimal screening and treatment of refractory skin disease.",
author = "Arkin, {L. M.} and K. Buhr and H. Brandling-Bennett and Y. Chiu and B. Chong and M. Curran and R. Hunt and Amy Paller and Werth, {V. P.} and Klein-Gitelman, {Marisa S} and {von Scheven}, E. and Kaveh Ardalan",
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Arkin, LM, Buhr, K, Brandling-Bennett, H, Chiu, Y, Chong, B, Curran, M, Hunt, R, Paller, A, Werth, VP, Klein-Gitelman, MS, von Scheven, E & Ardalan, K 2019, 'Practice-based differences in paediatric discoid lupus erythematosus', British Journal of Dermatology. https://doi.org/10.1111/bjd.17780

Practice-based differences in paediatric discoid lupus erythematosus. / Arkin, L. M.; Buhr, K.; Brandling-Bennett, H.; Chiu, Y.; Chong, B.; Curran, M.; Hunt, R.; Paller, Amy; Werth, V. P.; Klein-Gitelman, Marisa S; von Scheven, E.; Ardalan, Kaveh.

In: British Journal of Dermatology, 01.01.2019.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Practice-based differences in paediatric discoid lupus erythematosus

AU - Arkin, L. M.

AU - Buhr, K.

AU - Brandling-Bennett, H.

AU - Chiu, Y.

AU - Chong, B.

AU - Curran, M.

AU - Hunt, R.

AU - Paller, Amy

AU - Werth, V. P.

AU - Klein-Gitelman, Marisa S

AU - von Scheven, E.

AU - Ardalan, Kaveh

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Background: Children with discoid lupus erythematosus (DLE) are at risk for disfigurement and progression to systemic lupus erythematosus (SLE). Consensus is lacking regarding optimal care for children with DLE. Objectives: The aim of this study was to compare practice patterns among paediatric dermatologists/rheumatologists treating paediatric DLE. Methods: An online survey was sent to 292 paediatric rheumatologists in the Childhood Arthritis and Rheumatology Research Alliance and 200 paediatric dermatologists in the Pediatric Dermatology Research Alliance. Consensus was defined as ≥ 70% agreement. Results: Survey response rates were 38% (76 of 200) for dermatology and 21% (60 of 292) for rheumatology. Both specialties agreed that screening labs should include complete blood counts with differential, urinalysis, complement levels, erythrocyte sedimentation rate, antinuclear antibody and other autoantibodies, hepatic function and renal function/electrolytes. Both specialties agreed that arthritis or nephritis should prompt intensified evaluation for SLE. No other patient features achieved consensus as disease-modifying risk factors. Hydroxychloroquine was agreed upon as first-line systemic therapy, but consensus was lacking for second- or third-line treatment. Conclusions: We found few areas of consensus and significant practice differences between paediatric dermatologists and rheumatologists treating DLE. Knowledge gaps include risk factors for SLE, optimal screening and treatment of refractory skin disease.

AB - Background: Children with discoid lupus erythematosus (DLE) are at risk for disfigurement and progression to systemic lupus erythematosus (SLE). Consensus is lacking regarding optimal care for children with DLE. Objectives: The aim of this study was to compare practice patterns among paediatric dermatologists/rheumatologists treating paediatric DLE. Methods: An online survey was sent to 292 paediatric rheumatologists in the Childhood Arthritis and Rheumatology Research Alliance and 200 paediatric dermatologists in the Pediatric Dermatology Research Alliance. Consensus was defined as ≥ 70% agreement. Results: Survey response rates were 38% (76 of 200) for dermatology and 21% (60 of 292) for rheumatology. Both specialties agreed that screening labs should include complete blood counts with differential, urinalysis, complement levels, erythrocyte sedimentation rate, antinuclear antibody and other autoantibodies, hepatic function and renal function/electrolytes. Both specialties agreed that arthritis or nephritis should prompt intensified evaluation for SLE. No other patient features achieved consensus as disease-modifying risk factors. Hydroxychloroquine was agreed upon as first-line systemic therapy, but consensus was lacking for second- or third-line treatment. Conclusions: We found few areas of consensus and significant practice differences between paediatric dermatologists and rheumatologists treating DLE. Knowledge gaps include risk factors for SLE, optimal screening and treatment of refractory skin disease.

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U2 - 10.1111/bjd.17780

DO - 10.1111/bjd.17780

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JO - British Journal of Dermatology

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Arkin LM, Buhr K, Brandling-Bennett H, Chiu Y, Chong B, Curran M et al. Practice-based differences in paediatric discoid lupus erythematosus. British Journal of Dermatology. 2019 Jan 1. https://doi.org/10.1111/bjd.17780