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Research Article
Jill Ferrari
University of East London - Stratford Campus
Corresponding Author
ORCiD: https://orcid.org/0000-0001-5233-203X
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background
Verrucae pedis (VPs) are a common viral infection of the skin seen in children. There are limited studies of the prevalence, duration and impact of VPs in children who are immunosuppressed. The studies available suggest that, in these children, the warts are more widespread and are more long-standing. The primary aim of this study was to determine the prevalence of VPs in children attending rheumatology clinics who may have some degree of immunosuppression due to their prescribed medication and compare this to the reported prevalence in the healthy population.
Method
Children attending out-patient rheumatology appointments who had a paediatric rheumatology consultant named as the lead clinician, were recruited. The young people were aged between four and 17 years old. A visual inspection of both feet was used to identify potential VPs. Diagnosis of a VP was confirmed on observation of the typical clinical features of a VP. The location, duration of presence, previous treatments, presence of VPs in other family members and psychological impact was recorded.
Results
A total of 71 children were included. Of the group, 55 children had no VPs present, 16 children had one or more VPs. The prevalence of VPs was 22.5%. Medication impacting on the immune system was prescribed in 80% of the group. There appeared to be no greater chance of having VPs if taking immunosuppressive medication than compared to having no medication (OR = 1.1, 95%CI 0.26 to 4.48, p = 0.46). Children with VPs tended to be 9 years old or older with few children in the older age range (13–17 yrs) having VPs suggesting that most VPs do resolve by the teenage years. In total, 37.5% of the young people with VPs had lesions that had been present for 24 months or more. Two-thirds of the subjects were not concerned about VPs being present and most subjects with a VP did not know what it was, but despite this the majority of subjects (81%) had sought treatment for the VPs.
Conclusion
Children with JIA and other rheumatic conditions have no greater prevalence of VPs compared to the general population. The VPs present were of a similar clinical type and did not seem to be more widespread or unusual as has been reported in other immunocompromised populations. The percentage of lesions remaining beyond 24 months was found to be slightly greater than has been reported in other healthy populations. The children in this study seemed to be less concerned psychologically about their VPs, despite this most families had sought treatment for the verrucae.
Keywords
Verruca Pedis, Juvenile Idiopathic Arthritis, Children
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CURRENT STATUS: Under Review
Version 1
Posted 10 Mar, 2021
No community comments so far
Editorial decision: Major revision
On 28 Mar, 2021
Review #2 received
Received 15 Mar, 2021
Review #3 received
Received 15 Mar, 2021
Review #1 received
Received 13 Mar, 2021
Reviewer #5 agreed
On 07 Mar, 2021
Reviewer #2 agreed
On 01 Mar, 2021
Reviewer #3 agreed
On 01 Mar, 2021
Reviewer #4 agreed
On 01 Mar, 2021
Reviewers invited
Invitations sent on 01 Mar, 2021
Reviewer #1 agreed
On 01 Mar, 2021
Reviews received
Received 01 Mar, 2021
Editor assigned
On 24 Feb, 2021
Submission checks complete
On 24 Feb, 2021
Editor invited
On 24 Feb, 2021
First submitted
On 23 Feb, 2021
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A new preprint design is coming!
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This preprint is under consideration at Journal of Foot and Ankle Research. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research Article
Jill Ferrari
University of East London - Stratford Campus
Corresponding Author
ORCiD: https://orcid.org/0000-0001-5233-203X
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Under Review
Version 1
Posted 10 Mar, 2021
No community comments so far
Editorial decision: Major revision
On 28 Mar, 2021
Review #2 received
Received 15 Mar, 2021
Review #3 received
Received 15 Mar, 2021
Review #1 received
Received 13 Mar, 2021
Reviewer #5 agreed
On 07 Mar, 2021
Reviewer #2 agreed
On 01 Mar, 2021
Reviewer #3 agreed
On 01 Mar, 2021
Reviewer #4 agreed
On 01 Mar, 2021
Reviewers invited
Invitations sent on 01 Mar, 2021
Reviewer #1 agreed
On 01 Mar, 2021
Reviews received
Received 01 Mar, 2021
Editor assigned
On 24 Feb, 2021
Submission checks complete
On 24 Feb, 2021
Editor invited
On 24 Feb, 2021
First submitted
On 23 Feb, 2021
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background
Verrucae pedis (VPs) are a common viral infection of the skin seen in children. There are limited studies of the prevalence, duration and impact of VPs in children who are immunosuppressed. The studies available suggest that, in these children, the warts are more widespread and are more long-standing. The primary aim of this study was to determine the prevalence of VPs in children attending rheumatology clinics who may have some degree of immunosuppression due to their prescribed medication and compare this to the reported prevalence in the healthy population.
Method
Children attending out-patient rheumatology appointments who had a paediatric rheumatology consultant named as the lead clinician, were recruited. The young people were aged between four and 17 years old. A visual inspection of both feet was used to identify potential VPs. Diagnosis of a VP was confirmed on observation of the typical clinical features of a VP. The location, duration of presence, previous treatments, presence of VPs in other family members and psychological impact was recorded.
Results
A total of 71 children were included. Of the group, 55 children had no VPs present, 16 children had one or more VPs. The prevalence of VPs was 22.5%. Medication impacting on the immune system was prescribed in 80% of the group. There appeared to be no greater chance of having VPs if taking immunosuppressive medication than compared to having no medication (OR = 1.1, 95%CI 0.26 to 4.48, p = 0.46). Children with VPs tended to be 9 years old or older with few children in the older age range (13–17 yrs) having VPs suggesting that most VPs do resolve by the teenage years. In total, 37.5% of the young people with VPs had lesions that had been present for 24 months or more. Two-thirds of the subjects were not concerned about VPs being present and most subjects with a VP did not know what it was, but despite this the majority of subjects (81%) had sought treatment for the VPs.
Conclusion
Children with JIA and other rheumatic conditions have no greater prevalence of VPs compared to the general population. The VPs present were of a similar clinical type and did not seem to be more widespread or unusual as has been reported in other immunocompromised populations. The percentage of lesions remaining beyond 24 months was found to be slightly greater than has been reported in other healthy populations. The children in this study seemed to be less concerned psychologically about their VPs, despite this most families had sought treatment for the verrucae.
Figure 1
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