The Significance of Skin Manifestations in the Practice of Pediatric Rheumatology: Real-Life Data

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Abstract
Objective: Cutaneous manifestations can indicate various systemic diseases, including rheumatological, metabolic, endocrinological, infectious, gastrointestinal, and oncological disorders. The study aimed to examine the demographic, clinical, and laboratory characteristics as well as the final diagnoses of pediatric patients who presented with a rash complaint at a rheumatology clinic. Materials and Methods: This was a retrospective, cross-sectional, and descriptive study conducted at the pediatric rheumatology department of the center. The medical records of patients aged 0-18 years who presented with a rash as one of the initial complaints at the pediatric rheumatology clinic between January 2017 and December 2023 were reviewed. Data on demographics, clinical presentation, laboratory results, and final diagnosis were analyzed. Results: A total of 307 patients were included, including 166 women (54%). Of these, 255 (83%) were diagnosed with rheumatic disease. The most common rash type was petechiae/purpura (63.5%), followed by maculopapular rash (10%), urticarial rash (10.7%), and others. The most frequent rheumatic diagnosis was immunoglobulin A vasculitis. Other diagnoses include juvenile dermatomyositis, systemic lupus erythematosus, Kawasaki disease, and multisystem inflammatory syndrome in children. Conclusion: Skin manifestations often present as the initial complaint in pediatric rheumatic diseases. A thorough cutaneous examination is crucial for identifying the underlying systemic conditions and guiding appropriate management.