Peer-review started: September 30, 2014
First decision: October 28, 2014
Revised: February 25, 2015
Accepted: April 1, 2015
Article in press: April 7, 2015
Published online: May 2, 2015
Autoimmune connective tissue diseases are chronic inflammatory disorders associated with complex genetic and environmental interplay resulting in a variety of cutaneous and systemic manifestations. Pediatric onset of these disorders carries a unique diagnostic pressure for the clinician due to the potential years of disease burden and complications. Mortality and morbidity from these disorders has fallen dramatically over the past fifty years due to increasing awareness of these disease sequelae and utilization of systemic treatment modalities when necessary. This review highlights the clinical features that are unique to pediatric presentations of lupus erythematosus, juvenile idiopathic arthritis, juvenile dermatomyositis, juvenile onset systemic sclerosis and morphea. Each of these disorders has a distinct appearance corresponding to a particular cutaneous and systemic clinical course and prognosis. Awareness of the associated potential systemic complications can also alert the clinician to make astute management decisions when confronted with a probable rheumatologic case. Cutaneous symptoms may predate onset of systemic symptoms and by keeping the rheumatologic differential diagnoses in mind, the dermatologist can play a key role in potentially offsetting autoimmune disease burden in children.
Core tip: Early recognition of cutaneous manifestations of connective tissue disease can positively impact disease course. This review summarizes key cutaneous findings of some of the more common pediatric autoimmune connective tissue disorders, including lupus erythematosus, neonatal lupus, juvenile idiopathic arthritis, juvenile dermatomyositis, systemic sclerosis, and morphea.