Аннотация

Резюме

To develop and perform an extended statistical evaluation of a clinical and dermoscopic model for early risk stratification of severe psoriasis in children at the stage of initial examination.

Материал и методы

The study included 168 children aged 7–17 years with psoriasis. Based on serological examination, groups with and without herpes virus infection were formed. The outcome was severe disease before treatment, defined as PASI >20. The model included the presence of herpes virus infection and the total dermoscopic score. Binary logistic regression, ROC analysis, calibration assessment, bootstrap validation, repeated 10-fold cross- validation, and clinical utility analysis were used.

Результаты

The presence of herpes virus infection increased the odds of severe disease 3.636-fold, and an increase in the total dermoscopic score by 1 point increased the odds 1.585-fold. The area under the ROC curve was 0.835, optimal probability threshold 0.259, sensitivity 0.800, specificity 0.812. The Brier score was 0.103; the Hosmer–Lemeshow test showed p = 0.070. Bootstrap-corrected AUC was 0.828; mean AUC in repeated 10-fold cross-validation was 0.828.

Заключение

The proposed model can be used as a tool for early risk stratification of severe psoriasis in children at the stage of initial examination.

Ключевые слова

children psoriasis herpes virus infection dermoscopy risk stratification ROC analysis

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Список литературы

  1. 1. Axler EN, Bellet JS, Lipner SR. Tackling inflammatory and infectious nail disorders in children. Cutis. 2024;114(1):E9-E15.
  2. 2. Branisteanu DE, Georgescu S, Serban IL, et al. Management of psoriasis in children (review). Exp Ther Med. 2021;22(6):1429.
  3. 3. Chen YW, Lee CY, Tseng HC, et al. Increased risk of psoriasis: an immune sequela of herpes zoster? Evidence from a nationwide population-based cohort study. Australas J Dermatol. 2023;64(1):92-99.
  4. 4. Golińska J, Sar-Pomian M, Rudnicka L. Diagnostic accuracy of trichoscopy in inflammatory scalp diseases: a systematic review. Dermatology. 2022;238(3):412-421.
  5. 5. Menter A, Cordoro KM, Davis DMR, et al. Joint American Academy of Dermatology–National Psoriasis Foundation guidelines of care for the management and treatment of psoriasis in pediatric patients. J Am Acad Dermatol. 2020;82(1):161-201.
  6. 6. Morita A, Saeki H. Pediatric psoriasis: understanding pathological conditions and advances in treatment. J Dermatol. 2024;51(2):185-195.
  7. 7. Nejad KG, Khodadadi A, Mostafaei S, et al. Matching between clinical examination and dermoscopy in patients with nail psoriasis: should dermoscopy be used instead of clinical examination? Heliyon. 2024;10(8):e29608.
  8. 8. Oon HH, Theng CTS, Tey HL, et al. 2023 guidelines on the management of psoriasis by the Dermatological Society of Singapore. Ann Acad Med Singap. 2024;53(9):562-577.
  9. 9. Sendrea AM, Iorga D, Dascalu M, et al. HOMA-IR index and pediatric psoriasis severity: a retrospective observational study. Life. 2024;14(6):700.
  10. 10. Ting SW, Ting SY, Lin YS, et al. Risk of herpes zoster in psoriasis patients receiving systemic therapies: a nationwide population-based cohort study. Sci Rep. 2021;11:11824.
  11. 11. Wu Y, Sun L. Clinical value of dermoscopy in psoriasis. J Cosmet Dermatol. 2024;23(2):370-381.
  12. 12. Yang A, Cheng B, Seyger MMB, et al. The burden of pediatric psoriasis: a systematic review. Am J Clin Dermatol. 2025;26(5):695-710.