Psoriasis in children
Psoriasis is a chronic inflammatory autoimmune skin disease characterized by clearly demarcated red plaques that have a well-adhered scale on their surface due to the excessive proliferation of the outer layer of the epidermis, the stratum corneum.
Psoriasis can occur both in childhood and adolescence and in adulthood. Plaque psoriasis is the most common form of psoriasis in children compared to other forms such as guttate, pustular and erythrodermic. The most common areas of occurrence in children are the face, scalp and paratrim areas (genitals, axillae, etc.). In the appearance of psoriasis, environmental factors such as infections, medications, stress and genetic factors play an important role, as the heredity of the disease has been proven for a long time.
The most common forms of psoriasis in children are plaque psoriasis, where clearly demarcated red plaques appear on the face, elbows, knees and scalp with itching most of the time. Guttate psoriasis is the second most common form of psoriasis in children and is characterized by small, drop-shaped plaques scattered on the trunk, where the characteristic of this form is that patients most often have a prior streptococcal infection.
The pustular-erythrodermic form is quite rare in children and is characterized by generalized pustules on a red base, aseptic with a risk of infection. The pustular form can very quickly develop into generalized erythroderma, a serious condition in which the child may require hospitalization.
The clinical diagnosis of Psoriasis is relatively easy by an experienced dermatologist as the lesions are characteristic. In case of doubt, a skin punch biopsy is the best diagnostic method.
The choice of the appropriate treatment is made mainly based on the extent of the disease but also taking into account the psychological burden on the child. Usually, Psoriasis in children is mild with a few plaques scattered on the trunk and perhaps on the scalp. In these cases, local treatment is appropriate with corticosteroids being our first choice. In cases of extensive disease or intense psychological burden on the child, then we will proceed to systemic treatment with very good results.
