title: Psoriasiform eruptions during Kawasaki disease (KD): A distinct phenotype.
abstract: BACKGROUND
  A psoriasis-like eruption develops in a subset of patients with Kawasaki disease (KD).
  
  
  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.
  
  
  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.
  
  
  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.
  
  
  CONCLUSIONS
  The study was limited by the small number of cases, treatment variation, and availability of skin biopsy specimens.
  
  
  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.
authors.affiliation: School of Medicine, University of California, San Diego in La Jolla, California.
authors.forename: Ellen S
authors.initials: ES
authors.lastname: Haddock
authors.affiliation: Department of Dermatology, University of California, San Diego, California; Compass Dermatopathology, La Jolla, California.
authors.forename: Antoanella
authors.initials: A
authors.lastname: Calame
authors.affiliation: Department of Pediatrics, University of California, San Diego, California; Rady Children's Hospital, San Diego, California.
authors.forename: Chisato
authors.initials: C
authors.lastname: Shimizu
authors.affiliation: Department of Pediatrics, University of California, San Diego, California; Rady Children's Hospital, San Diego, California.
authors.forename: Adriana H
authors.initials: AH
authors.lastname: Tremoulet
authors.affiliation: Department of Pediatrics, University of California, San Diego, California; Rady Children's Hospital, San Diego, California.
authors.forename: Jane C
authors.initials: JC
authors.lastname: Burns
authors.affiliation: Department of Dermatology, University of California, San Diego, California; Department of Pediatrics, University of California, San Diego, California; Rady Children's Hospital, San Diego, California. Electronic address: wtom@rchsd.org.
authors.forename: Wynnis L
authors.initials: WL
authors.lastname: Tom
mesh_terms: D000293:Adolescent; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D055233:Cornified Envelope Proline-Rich Proteins / Q000235:genetics; D005260:Female; D005838:Genotype; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D053536:Keratin-16 / Q000032:analysis; D019394:Ki-67 Antigen / Q000032:analysis; D008297:Male; D009080:Mucocutaneous Lymph Node Syndrome / Q000150:complications* / Q000235:genetics / Q000473:pathology*; D010641:Phenotype; D011379:Prognosis; D011565:Psoriasis / Q000209:etiology* / Q000235:genetics / Q000378:metabolism / Q000473:pathology*; D012189:Retrospective Studies; D017384:Sequence Deletion
chemical_list: D055233:Cornified Envelope Proline-Rich Proteins; D053536:Keratin-16; D019394:Ki-67 Antigen; C549748:LCE3B protein, human; C524768:LCE3C protein, human
keywords: Kawasaki disease; Ki-67; LCE3C_LCE3B deletion; keratin 16; psoriasiform; psoriasis