Psoriasis in children

Abstract

The clinical presentation, disease associations, and diverse treatment modalities in overcoming the challenges of managing pediatric psoriasis have been extensively summarized in this article. An extensive literature review revealed the differences in presentation of psoriasis during infancy, childhood, and adolescence. We also summarized the latest topical, systemic, and biological modalities in treating recalcitrant psoriasis. The association of psoriasis with juvenile arthritis and obesity and the significant influence of the disease on the children’s quality of life were explored. The clinical presentation of psoriasis can evolve during the child’s lifespan. While many treatment modalities already exist for treating pediatric psoriasis, some of the new biologics that are approved for adult patients have not been investigated in the pediatric population and no algorithm exists for their use in this population. Large clinical studies in the future will enhance our understanding with regards to their safety and potential implications in pediatric populations.

Is it just simple dermatitis or eczema?

“…Diagnosis of psoriasis is more challenging during childhood due to its unusual clinical appearances. Psoriasis is known to be a frequent protracted inflammatory skin disorder affecting 0.5%-2% of children and 2%-4% of the general population, although infants are rarely affected (1)(2)(3)(4). Although the extensors of the limbs, scalp, and flexures are the key body areas affected in childhood psoriasis, the face, periauricular area, and eyelids are also usually involved such as in the present patient.…”

“…Plaque formation on the scalp is common and may be tough to distinguish from that observed in seborrheic dermatitis. Psoriasis in the napkin area is often confused with irritant or seborrheic dermatitis or Candidiasis (4,5).…”

Iatrogenic Cushing's syndrome due to topical steroid abuse in a child with Psoriasis presenting as septicaemia

“…6 The prevalence of childhood psoriasis in ages of 0-9 years in a study done in United Kingdom was 0.55% and in age group of 10-19 years was found to be 1.37%. 7 Acute generalized pustular psoriasis (GPP) occurs in patients with a prior diagnosis of psoriasis vulgaris in about 65% of the cases. 8,9 Abrupt withdrawal of corticosteroids can lead to acute inflammatory cascade precipitating acute GPP; as was seen in our case.…”

Management of youth psoriatic arthritis with etanercept: a case report

“…Psoriatic disease development is dependent of several cell types such as dendritic cells, macrophages, T cells and keratinocytes which induce an increase of an array of pro-inflammatory cytokines 20 . In childhood, PsA affects approximately one-third of the PsO cases and it is well known that children suffering of PsA might develop cardiovascular diseases besides other chronic inflammatory illness as Crohn's disease and obesity 21 .…”