Recognition and treatment of psoriasis in children

Abstract 

Psoriasis frequently presents in childhood and is usually easily recognized. Mild disease or an atypical presentation may present diagnostic difficulty. There are many clinical patterns, and anogenital, facial and guttate lesions are particularly well recognized in this age group. Education of children and parents about disease chronicity and treatment options is essential for successful management. Most patients respond to topical treatment with emollients, coal tar, dithranol or calcipotriol. Supervision of the application of topical medicaments in a daycare setting, or admission to a ward, may be necessary if response to outpatient treatment is disappointing. Phototherapy with ultraviolet B may be combined with topical treatment in older children with more extensive disease. A minority of children with particularly severe disease require systemic therapy. Retinoids are the most commonly used agents. There are few published data regarding methotrexate or cyclosporin in childhood psoriasis, although these agents appear to have a role in those most severely affected.

Keywords:  childhood psoriasis, genetic factors, environmental triggers, clinical forms, management strategies