Hautzeichen bei rheumatologischen Erkrankungen im Kindes- und Jugendalter

Zusammenfassung

Rheumatologische Erkrankungen können sich in einer großen Vielfalt an der Haut manifestieren. Das Spektrum reicht von flüchtigen Exanthemen bis zu tiefer Sklerosierung, Vaskulitis und Pannikulitis. Dank der Zugänglichkeit für Inspektion, Dermatoskopie, Palpation und Biopsien können dermatologische Mitbeurteilungen wertvolle Hinweise für die diagnostische Einordnung geben. Während bei einigen rheumatologischen Erkrankungen, wie kutanem Lupus erythematodes oder Sklerodermie, spezifische Hautzeichen leicht mit dem Auge zu erkennen oder mit den Fingern zu ertasten sind, sind Hautzeichen wie Exantheme, leukozytoklastische Vaskulitis oder Erythema nodosum klar definierte Entitäten, die jedoch verschiedene Ursachen haben können. Gerade im Kindesalter müssen die häufigen, transienten infektassoziierten Varianten von immunologischen Grunderkrankungen abgegrenzt werden. Die Symptome sind teilweise inkomplett oder atypisch und können weiteren Manifestationen vorausgehen, was interdisziplinäre Verlaufsbeurteilungen erfordert. Die hier vorgestellten Hautzeichen rheumatologischer Erkrankungen im Kindes- und Adoleszentenalter illustrieren den Wert einer engen interdisziplinären Zusammenarbeit.

Summary

Rheumatologic diseases can come with an extraordinary wide spectrum of skin manifestations ranging from transient erythema to massive sclerosis of deep connective tissue layers, vasculitis or panniculitis. Thanks to its accessibility for inspection, dermatoscopy, palpation and biopsy, dermatological assessment can provide valuable clues for the diagnostic classification.

While some diseases such as cutaneous lupus erythematodes, scleroderma or Gottron’s papules in dermatomyositis are specific features of the associated disease, skin signs such as exanthema, leukocytoclastic vasculitis or erythema nodosum are unspecific with regard to the trigger. Especially in childhood, the frequent infect-associated transient manifestations have to be carefully differentiated from underlying immunological diseases. Because symptoms can be atypical or incomplete and frequently precede systemic involvement, interdisciplinary follow-ups are crucial.

Herein we review typical skin signs of underlying rheumatologic diseases in children and adolescents to illustrate the complementary value of close interdisciplinary collaboration between pediatric rheumatology and pediatric dermatology.

Schlüsselwörter

Figurierte Exantheme - Kollagenose - Vaskulitis - Vaskulopathie - Pannikulitis

Keywords

Figurate exanthema - mixed connective tissue disease - vasculitis - vasculopathy - panniculitis

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