Psoriasiform eruptions during Kawasaki disease (KD): A distinct phenotype

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• 作者：Ellen S. Haddock ; AB ; MBA^a ; Antoanella Calame ; MD^b ; ^d ; Chisato Shimizu ; MD^c ; ^e ; Adriana H. Tremoulet ; MD^c ; ^e ; Jane C. Burns ; MD^c ; ^e ; Wynnis L. Tom ; MD^b ; ^c ; ^e ; ^{wtom@rchsd.org" class="auth_mail" title="E-mail the corresponding author}
• 关键词：Kawasaki disease ; keratin 16 ; Ki-67 ; LCE3C_LCE3B deletion ; psoriasiform ; psoriasis
• 刊名：Journal of the American Academy of Dermatology
• 出版年：2016
• 出版时间：July 2016
• 年：2016
• 卷：75
• 期：1
• 页码：69-76.e2
• 全文大小：1574 K

文摘

A psoriasis-like eruption develops in a subset of patients with Kawasaki disease (KD).

c_2">Objective

We sought to systematically compare KD-associated psoriasiform eruptions with classic psoriasis and the outcomes of KD in children with and without this rash.

c_3">Methods

This was a retrospective study of 11 KD cases with a psoriasiform eruption matched 1:2 by age, gender, and ethnicity with psoriasis-only and KD-only controls. Genotyping was performed in 10 cases for a deletion of 2 late cornified envelope (LCE) genes, LCE3C_LCE3B-del, associated with increased risk for pediatric-onset psoriasis.

c_4">Results

Similar to classic psoriasis, KD-associated eruptions were characterized clinically by well-demarcated, scaly pink plaques and histopathologically by intraepidermal neutrophils, suprabasilar keratin 16 expression, and increased Ki-67 expression. They showed less frequent diaper area involvement, more crust and serous exudate, and an enduring remission (91% vs 23% with confirmed resolution; P < .001). Frequency of LCE3C_LCE3B-del and major KD outcomes were similar between cases and controls.

c_5">Limitations

The study was limited by the small number of cases, treatment variation, and availability of skin biopsy specimens.

c_6">Conclusions

Although the overall clinical and histopathologic findings were similar to conventional psoriasis, this appears to be a distinct phenotype with significantly greater propensity for remission. No adverse effect on KD outcomes was noted.