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Psoriasis and associated variables in classification and outcome of juvenile idiopathic arthritis - an eight-year follow-up study
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health. Ryhov Cty Hosp, Dept Pediat, Jonkoping, Sweden..
Univ Helsinki Hosp, Childrens Hosp, Dept Pediat, Helsinki, Finland..
Gothenburg Univ, Sahlgrenska Acad, Inst Clin Sci, Dept Pediat, Gothenburg, Sweden..
Arhus Univ Hosp, Dept Pediat, Aarhus, Denmark..
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2017 (English)In: Pediatric Rheumatology, ISSN 1546-0096, E-ISSN 1546-0096, Vol. 15, article id 13Article in journal (Refereed) Published
Abstract [en]

Background: To study the impact of psoriasis and features associated with psoriasis on classification and outcome in a population-based follow-up cohort of children with juvenile idiopathic arthritis (JIA). Methods: In all, 440 children with JIA were followed for a median of 8 years in a prospective Nordic population-based cohort study. Data for remission was available for 427 of these children. The presence of psoriasis, psoriasis-like rash, dactylitis, nail pitting, enthesitis, tenosynovitis and heredity was assessed in relation to ILAR classification and remission. Results: Clinical findings associated with psoriasis developed consecutively during the 8-year period. Six of 14 children with psoriasis were not classified as juvenile psoriatic arthritis according to the ILAR criteria at 8 year follow-up. Dactylitis was more common in children with early onset of JIA. After 8 years we found a cumulative median number of eleven arthritic joints in children with psoriasis or psoriasis- like rash compared with six in the rest of the cohort (p = 0.02). Also, the chance for not being in remission after 8 years increased significantly in patients with psoriasis, psoriasis-like rash or at least two of: 1) first-degree heredity for psoriasis or psoriatic arthritis, 2) dactylitis or 3) nail pitting, compared with the rest of the group (OR 3.32, p = 0.010). Conclusions: Our results indicate a more severe disease over time in psoriasis- associated JIA, as features of psoriasis develop during the disease course. This group is a major challenge to encompass in a future JIA classification in order to facilitate early tailored treatment.

Place, publisher, year, edition, pages
BioMed Central, 2017. Vol. 15, article id 13
Keywords [en]
Arthritis, Juvenile Rheumatoid, Psoriasis, Child
National Category
Pediatrics Rheumatology and Autoimmunity
Identifiers
URN: urn:nbn:se:uu:diva-320455DOI: 10.1186/s12969-017-0145-5ISI: 000397321900001PubMedID: 28222745OAI: oai:DiVA.org:uu-320455DiVA, id: diva2:1091487
Available from: 2017-04-26 Created: 2017-04-26 Last updated: 2017-04-26Bibliographically approved

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