Psoriasis can be difficult to diagnose in children. In a study, researchers sought to test the diagnostic accuracy of diagnostic criteria for childhood psoriasis. This study was published in the British Journal of Dermatology.
This study took place across 12 dermatology departments in the United Kingdom between 2017 and 2019. The researchers assessed 18 clinical criteria using blinded investigators. In total, 160 children aged younger than 18 years with dermatologist diagnosed psoriasis were compared with 170 control subjects with a different scaly inflammatory rash.
A consensus agreed criteria and scoring algorithm was used to assess patients, and this algorithm demonstrated a sensitivity of 84.4%, specificity of 65.1%, and area under the curve (AUC) of 0.75. The seven diagnostic criteria that showed the best fit were:
- Scale/erythema in the scalp and hairline
- Scale/erythema inside external auditory meatus
- Persistent well-demarcated erythematous rash anywhere on the body
- Scaly erythematous plaques on extensor surfaces of elbows/knees
- Persistent erythema in the umbilicus
- Well-demarcated erythematous rash in the napkin area involving the crural folds
- Family history of psoriasis
The sensitivity of the best predictive model was 76.8%, specificity was 72.7%, and AUC was 0.84.
The authors concluded, “This study provides examination and history-based data on the clinical features of psoriasis in children and proposes seven diagnostic criteria with good discriminatory ability in secondary care patients. External validation is now needed.”
Link: British Journal of Dermatology https://onlinelibrary.wiley.com/doi/10.1111/bjd.20689