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Πέμπτη 26 Νοεμβρίου 2020

Pediatric Psoriasis

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Abstract

Psoriasis is a chronic multi-system inflammatory condition with an autoimmune component. One-third to one-half of cases have onset in childhood. There are a variety of pediatric variant types of psoriasis, including generalized disease, that is similar to adult psoriasis, and types distinctive to childhood, including diaper involvement and pityriasis amiantacea. Pediatric psoriasis is associated with infectious triggers and exacerbation by the Koebner phenomenon. Children with psoriasis may have more of a tendency toward obesity as reflected by a large waist circumference. More extensive disease in childhood is associated with a poor quality of life, anxiety, and depression. Therapeutics of pediatric psoriasis generally requires a global approach including identifying infectious triggers, addressing health risks including obesity, and psychological support. Prescription care includes application of mid-potency topical corticosteroids and/or calcipotrie ne, phototherapy with Narrowband UVB or excimer laser. In severe cases, cyclic prescribing of systemic agents for 6–12 months including methotrexate, cyclosporine, etanercept, adalimumab, and recently approved agents ixekizumab and ustekinumab can aid in disease clearance with minimization of side effects. Emerging studies for the efficacious and safe use of biologics in children broaden treatment options for managing severe psoriatic disease early.

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