AB0997 Children with Psoriasis and Arthritis – an Important Clinical and Prognostic Issue That Challenges the Ilar-Classification. (9th June 2015)

• Record Type: Journal Article
• Authors: Ekelund, M.; Aalto, K.; Fasth, A.; Herlin, T.; Nielsen, S.; Nordal, E.; Peltoniemi, S.; Rygg, M.; Zak, M.; Berntson, L.
• Is Part Of: Annals of the rheumatic diseases. Volume 74(2015)Supplement 2
• Page Start: 1231
• Page End: 1232
• Publication Date: 2015-06-09
• Subjects: Rheumatism -- Periodicals; 616.723005
• DOI: 10.1136/annrheumdis-2015-eular.2313
• Languages: English
• ISSNs: 0003-4967

Abstract

Abstract : Background: Among pediatric rheumatologists there is an on-going discussion whether juvenile psoriatic arthritis is an entity of its own or not. It is recognized that psoriatic arthritis is a disease with both autoimmune and autoinflammatory features. The ILAR-classification of psoriatic arthritis is under debate. Objectives: To study clinical signs, classification, and outcome in children with juvenile idiopathic arthritis (JIA) and psoriasis/psoriasis-like rash in a population-based cohort during the first eight years of disease. Methods: In total 440 children with JIA were included prospectively in a population-based cohort study. The presence of psoriasis and psoriasis-like rash during an eight years follow-up period was assessed in relation to clinical characteristics, ILAR-classification and remission. Results: - Of the 440 children 14 developed psoriasis and 13 psoriasis-like rash during the first eight years of disease. 8/14 children with psoriasis and JIA were classified as juvenile psoriatic arthritis (JPA). 6/14 children with psoriasis and JIA were classified as undifferentiated JIA. One was RF positive and the other five had concurrent signs of enthesitis-related arthritis. Children with dactylitis and/or nail-pitting were spread among many ILAR categories. Children with JIA and psoriasis/psoriasis-like rash had significantly higher number of cumulative active joints during the first eight years from disease onset than children with no psoriasis/psoriasis-like rash (p=0.02). Dactylitis, nail pitting and enthesitis were significantly more common (0.01, <0.001, 0.03) in children with psoriasis/psoriasis-like rash compared to the rest of the cohort. Children with and without psoriasis/psoriasis-like rash had the same outcome with regards to remission status after eight years. Conclusions: ILAR-criteria exclude children with spondylitis and enthesitis-related features from the JPA category. We suggest that this is not clinically relevant. Our results indicate a more severe disease course in children with psoriasis/psoriatisis-like rash and JIA, but the number of children with psoriasis/psoriasis-like rash was limited. There is a need to study children with psoriasis and arthritis in more detail regarding clinical pattern and prognosis. Disclosure of Interest: None declared