Abstract
Psoriasis (Ps) is a T-cell-mediated chronic inflammatory disorder of the skin seen in about 3.5% of the population. One-third of Ps cases in dermatology center are pediatric patients. Pediatric Ps consists broadly of three age groups of psoriatic patients: infantile Ps, a self-limited disease of infancy, Ps with early onset and pediatric Ps with psoriatic arthritis. Timely diagnosis and appropriate management can not only arrest progression but also minimize the psychosocial burden imposed by this illness thereby averting disfiguring states and its evolution into a metabolic syndrome requiring extensive treatment. This review will cover almost all aspects of pediatric Ps including the rare clinical form congenital erythrodermic Ps and present the latest update especially on the etiopathogenesis and treatment options.
Financial & competing interests disclosure
The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.
No writing assistance was utilized in the production of this manuscript.
Key issues
• Psoriasis (Ps) in children is not uncommon.
• Ps is a systemic, immune-mediated disorder, characterized by inflammatory skin and joint manifestations.
• Both atopic dermatitis and Ps share epidermal hyperplasia, aberrant immunity and skin barrier anomalies. They also appear in the same individual or family.
• The ‘march of psoriasis’ describes the disease process where in, the disease starts with a genetic background and progresses in a stepwise manner to subsequent comorbidities due to chronic inflammation.
• An effective therapy starts with counseling the patient and parent, explaining to them the nature of the disease, treatment options available, their pros and cons.
• It is best to always wait diligently for a short period of 1–2 weeks for the erythrodermic version of the disease to evolve fully in children before plunging to systemic medications.
• One has to remember that any form of light therapy has to be commenced in children with enough considerations and thoughtfulness of the child being exposed to ultraviolet light-containing sunlight for many more years to come in their life time.
• The afflicted children must be taught to cope with life and to adapt to their individual health situation.
• Early detection, appropriate management will avoid comorbidities that are likely to develop in adulthood due to chronic inflammation.