Diagnostic criteria for psoriasis in children
Research type
Research Study
Full title
Developing diagnostic criteria for psoriasis in children and young people: a multi-centre case control study in paediatric dermatology clinics
IRAS ID
220116
Contact name
Kim Thomas
Contact email
Duration of Study in the UK
2 years, 0 months, 1 days
Research summary
Summary of Research
Why is this research needed?
Psoriasis is a skin condition that can cause red, flaky patches on any part of the body including the face, scalp, hands and genitals. Children and young people with psoriasis can develop an inflammatory arthritis leading to swelling, discomfort and permanent joint damage. Psoriasis may also lead to obesity and long-term health problems such as high blood pressure and diabetes. It is therefore important that psoriasis is diagnosed accurately and early, so that specific treatment and monitoring can be started.Psoriasis is often difficult to diagnose in children and young people. Research shows that up to nine in ten children with psoriasis are mistakenly diagnosed with other skin conditions by non-dermatologists.
What important question will be answered?
How well do the expert agreed diagnostic criteria for psoriasis perform at diagnosing psoriasis in children/young people (17 years or younger) and can the diagnostic criteria be improved?How will this research be done?
A group of experts in psoriasis from around the world have already agreed a list of diagnostic criteria that are important for the diagnosis of psoriasis in children/young people. In this study, the agreed diagnostic criteria will be tested in children/young people with psoriasis and children/young people with other skin conditions in a study type called a case control study. This study will assess how well the criteria separate these two groups. The results will be used in a statistical model to refine the diagnostic criteria by removing those that poorly predicted psoriasis. Children and young people recruited to the study will attend for one study visit lasting approximately 30 minutes.Where will this research be done?
The study will take place in children’s’ dermatology departments across the UK. The research will be led from the University of Nottingham.Summary of Results
Psoriasis is a skin condition that can cause red, flaky patches on any part of the body including the face, scalp, hands and genitals. It can affect up to 2% of children worldwide, but this varies between countries. Children with psoriasis can develop an inflammatory arthritis and long-term health problems. Therefore, it important that psoriasis is diagnosed accurately and early, so that specific treatment and monitoring can be started.
The DIPSOC study was designed to develop DIagnostic criteria for PSOriasis in Children and young people. The study tested how well a list of expert-agreed diagnostic criteria (skin changes to look for and questions to ask about in the medical history) performed at separating psoriasis from other scaly red rashes in children. Three hundred and thirty children were recruited from 12 dermatology departments across England, Wales and Scotland.
The expert-agreed criteria were able to correctly find psoriasis in more than eight out of 10 children. The list of 16 items were refined using a statistical model. Seven criteria were found to be most useful. These were red flaky patches on the scalp, inside the ear, on the body with clearly defined edges, on the back of the elbow or front of the knee, in the umbilicus, in the groin creases where a nappy would be, and finally psoriasis in a family member. If two or more of these seven criteria are positive in the history and examination, then psoriasis will be correctly identified in close to eight out of ten children.
REC name
East Midlands - Nottingham 2 Research Ethics Committee
REC reference
17/EM/0035
Date of REC Opinion
3 Feb 2017
REC opinion
Further Information Favourable Opinion