This is a cross-sectional study performed between January 2019 and December 2019 by a collaboration between a tertiary pediatric dermatology and pediatric rheumatology clinic. The study group consists of pediatric Pso patients who were diagnosed in the dermatology outpatient clinics and control group is age/gender-matched randomly selected healthy volunteers.
Pso is classified according to the pattern of distribution (inverse, flexor, and seborrheic), morphology (plaque, guttat, erythrodermic, pustular, rupioid, and elephantine) and anatomic site (scalp, palmoplantar, genital, nail and, anal Pso) [9 (link)]. A pediatric dermatologist examined all patients and recorded their age at disease onset, Pso subtype, presence of nail involvement, and previous medications prescribed for cutaneous or nail Pso. Furthermore, all of them were questioned for the presence of arthralgia, arthritis, morning stiffness, hip pain, lower back pain, and heel pain in dermatology outpatient clinic. Special standardized evaluation forms were used (Appendix 1 ). Subsequently, pediatric patients with Pso were referred to pediatric rheumatology outpatient clinic.
Healthy controls (HCs) were the volunteers that visited pediatric outpatient clinics for either vaccination or general control. All of them were evaluated by the same questionnaire in pediatric rheumatology outpatient clinic (Appendix 2 ).
At pediatric rheumatology outpatient clinic, patients with Pso and healthy individuals were initially examined by two pediatric rheumatologists (HES and SGK) and two fellows (AT and FC). Demographic data, including age, sex, weight, height, family history, and comorbidities were also recorded. Subsequently, all patients and HCs were subjected to articular and entheseal examination. Modified Schober’s test was performed to all patients and HCs for the evaluation of range of motion of lumbar spine. Measurements of <6 cm were regarded as abnormal. Finally, entheseal thickness of the Achilles tendon was measured by ultrasonography (US). The US examinations were performed in a darkened room by an expert pediatric rheumatologist (NAA), using an US (Venue 40, GE Healthcare) equipped with a broadband 6–18 MHz linear probe. The rheumatologist who performed US was blinded to the patients’ diagnoses, questionnaire responses and physical examinations, as well. The thickness of the Achilles tendon was measured at longitudinal section with the probe parallel to the tendon’s alignment, near to its insertion onto the calcaneus.
The study was reviewed and approved by the Kanuni Sultan Suleyman Training and Research Hospital Clinical Research Ethics Committee (Ethics approval number: KAEK/2018.6.13) and the parents/patients gave a written consent approving to be a participant of this study.
Pso is classified according to the pattern of distribution (inverse, flexor, and seborrheic), morphology (plaque, guttat, erythrodermic, pustular, rupioid, and elephantine) and anatomic site (scalp, palmoplantar, genital, nail and, anal Pso) [9 (link)]. A pediatric dermatologist examined all patients and recorded their age at disease onset, Pso subtype, presence of nail involvement, and previous medications prescribed for cutaneous or nail Pso. Furthermore, all of them were questioned for the presence of arthralgia, arthritis, morning stiffness, hip pain, lower back pain, and heel pain in dermatology outpatient clinic. Special standardized evaluation forms were used (
Healthy controls (HCs) were the volunteers that visited pediatric outpatient clinics for either vaccination or general control. All of them were evaluated by the same questionnaire in pediatric rheumatology outpatient clinic (
At pediatric rheumatology outpatient clinic, patients with Pso and healthy individuals were initially examined by two pediatric rheumatologists (HES and SGK) and two fellows (AT and FC). Demographic data, including age, sex, weight, height, family history, and comorbidities were also recorded. Subsequently, all patients and HCs were subjected to articular and entheseal examination. Modified Schober’s test was performed to all patients and HCs for the evaluation of range of motion of lumbar spine. Measurements of <6 cm were regarded as abnormal. Finally, entheseal thickness of the Achilles tendon was measured by ultrasonography (US). The US examinations were performed in a darkened room by an expert pediatric rheumatologist (NAA), using an US (Venue 40, GE Healthcare) equipped with a broadband 6–18 MHz linear probe. The rheumatologist who performed US was blinded to the patients’ diagnoses, questionnaire responses and physical examinations, as well. The thickness of the Achilles tendon was measured at longitudinal section with the probe parallel to the tendon’s alignment, near to its insertion onto the calcaneus.
The study was reviewed and approved by the Kanuni Sultan Suleyman Training and Research Hospital Clinical Research Ethics Committee (Ethics approval number: KAEK/2018.6.13) and the parents/patients gave a written consent approving to be a participant of this study.
