Shades of grey: what is paediatric psoriasiform dermatitis and what does it have in common with childhood psoriasis?

While the majority of children with a chronic itchy rash suffer from atopic dermatitis (AD) and other forms of dermatitis, psoriasis is in the differential diagnosis. Certain patterns such as guttate and napkin psoriasis are accepted as classic paediatric psoriasis (PP), however there are many patients who do not fit these classic forms of OO nor fulfil the accepted criteria for AD. 'Psoriasiform dermatitis' (PD) is a term that has been used for these patients; however, it has not been formally defined. Identification of this group of patients, who although not having the typical clinical features of psoriasis, respond well to psoriasis-specific treatment, may assist treatment decisions for these patients.To describe PD and compare it with typical PP.Patients with classic PP (n = 109) were compared with a control group with aAD (n = 449) and assessed for 21 clinical features associated with PP. Multivariate nonlinear regression analyses determined which features best separated the groups. Patients with dermatitis who demonstrated any of these 21 features (n = 43), which were used to diagnose PD, were then compared with the PP and AD groups. They were managed with psoriasis-specific treatment and Psoriasis Area and Severity Index (PASI) was recorded.Of the 21 clinical features, 12 were found to clearly separate the classic paediatric psoriasis and AD groups. Using the eight most significant (P 

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