Vol 9, No 2 (2023)
Review paper
Published online: 2023-06-12
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Psoriasis in the pediatric population: clinical presentation, management and quality of life assessment

Magdalena Szczegielniak1, Aleksandra Lesiak1, Joanna Narbutt1
·
Forum Dermatologicum 2023;9(2):71-74.
Affiliations
  1. Department of Dermatology, Pediatric Dermatology and Oncology Clinic, Medical University of Lodz, Poland

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Vol 9, No 2 (2023)
REVIEW ARTICLES
Published online: 2023-06-12

Abstract

Psoriasis is a chronic, non-infectious, inflammatory immune-mediated skin disease. It progresses with periods of exacerbation and remission. Genetic, epigenetic, and environmental factors all play a role in the development of psoriasis. Psoriasis is a common dermatosis affecting both adults and children. The pediatric population has the same clinical subtypes of psoriasis as adults, while lesions may differ in distribution and morphology. Children are more likely to report skin pruritus and burning. The diagnosis of psoriasis is mainly based on clinical features. Psoriasis patients are predisposed to developing cardiovascular disease, metabolic syndrome, and its components, type 2 diabetes, and inflammatory bowel disease. Psoriasis can hurt the quality of life, school life, and peer interactions of children and adolescents. Treatment of children with psoriasis — should be individualized and selected according to the severity of the skin lesions and age. Topical medications are used to treat the mild form, while general conventional and biological treatment is used for the moderate and severe cases. This paper reviews the current state of knowledge on the clinical features, therapeutic management, and impact on the quality of life of psoriasis in the pediatric population.

Abstract

Psoriasis is a chronic, non-infectious, inflammatory immune-mediated skin disease. It progresses with periods of exacerbation and remission. Genetic, epigenetic, and environmental factors all play a role in the development of psoriasis. Psoriasis is a common dermatosis affecting both adults and children. The pediatric population has the same clinical subtypes of psoriasis as adults, while lesions may differ in distribution and morphology. Children are more likely to report skin pruritus and burning. The diagnosis of psoriasis is mainly based on clinical features. Psoriasis patients are predisposed to developing cardiovascular disease, metabolic syndrome, and its components, type 2 diabetes, and inflammatory bowel disease. Psoriasis can hurt the quality of life, school life, and peer interactions of children and adolescents. Treatment of children with psoriasis — should be individualized and selected according to the severity of the skin lesions and age. Topical medications are used to treat the mild form, while general conventional and biological treatment is used for the moderate and severe cases. This paper reviews the current state of knowledge on the clinical features, therapeutic management, and impact on the quality of life of psoriasis in the pediatric population.

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Keywords

psoriasis, children, comorbidities

About this article
Title

Psoriasis in the pediatric population: clinical presentation, management and quality of life assessment

Journal

Forum Dermatologicum

Issue

Vol 9, No 2 (2023)

Article type

Review paper

Pages

71-74

Published online

2023-06-12

Page views

2164

Article views/downloads

27

DOI

10.5603/FD.a2023.0009

Bibliographic record

Forum Dermatologicum 2023;9(2):71-74.

Keywords

psoriasis
children
comorbidities

Authors

Magdalena Szczegielniak
Aleksandra Lesiak
Joanna Narbutt

References (40)
  1. Relvas M, Torres T. Pediatric psoriasis. Am J Clin Dermatol. 2017; 18(6): 797–811.
  2. Bronckers IM, Paller AS, van Geel MJ, et al. Psoriasis in children and adolescents: diagnosis, management and comorbidities. Paediatr Drugs. 2015; 17(5): 373–384.
  3. Pinson R, Sotoodian B, Fiorillo L. Psoriasis in children. Psoriasis (Auckl). 2016; 6: 121–129.
  4. Schäkel K, Schön MP, Ghoreschi K. [Pathogenesis of psoriasis]. Hautarzt. 2016; 67(6): 422–431.
  5. Mahé E, Gnossike P, Sigal ML. [Childhood psoriasis]. Arch Pediatr. 2014; 21(7): 778–786.
  6. Eichenfield LF, Paller AS, Tom WL, et al. Pediatric psoriasis: evolving perspectives. Pediatr Dermatol. 2018; 35(2): 170–181.
  7. Mahé E. Childhood psoriasis. Eur J Dermatol. 2016; 26(6): 537–548.
  8. Elmets CA, Leonardi CL, Davis DMR, et al. Joint AAD-NPF guidelines of care for the management and treatment of psoriasis with awareness and attention to comorbidities. J Am Acad Dermatol. 2019; 80(4): 1073–1113.
  9. Takeshita J, Grewal S, Langan SM, et al. Psoriasis and comorbid diseases: Epidemiology. J Am Acad Dermatol. 2017; 76(3): 377–390.
  10. Oliveira Md, Rocha Bd, Duarte GV. Psoriasis: classical and emerging comorbidities. An Bras Dermatol. 2015; 90(1): 9–20.
  11. Wootton CI, Murphy R. Psoriasis in children: should we be worried about comorbidities? Br J Dermatol. 2013; 168(3): 661–663.
  12. Tollefson MM, Van Houten HK, Asante D, et al. Association of psoriasis with comorbidity development in children with psoriasis. JAMA Dermatol. 2018; 154(3): 286–292.
  13. Blegvad C, Nybo Andersen AM, Groot J, et al. Clinical characteristics including cardiovascular and metabolic risk factors in adolescents with psoriasis. J Eur Acad Dermatol Venereol. 2020; 34(7): 1516–1523.
  14. Torres T, Machado S, Mendonça D, et al. Cardiovascular comorbidities in childhood psoriasis. Eur J Dermatol. 2014; 24(2): 229–235.
  15. Kelati A, Baybay H, Najdi A, et al. Pediatric psoriasis: Should we be concerned with comorbidity? Cross-sectional study. Pediatr Int. 2017; 59(8): 923–928.
  16. Badaoui A, Tounian P, Mahé E. Psoriasis and metabolic and cardiovascular comorbidities in children: A systematic review. Arch Pediatr. 2019; 26(2): 86–94.
  17. Jensen P, Zachariae C, Iversen L, et al. Cardiovascular risk factors in children and adolescents with psoriasis: a case-control study. Acta Derm Venereol. 2014; 94(1): 76–78.
  18. Phan K, Lee G, Fischer G. Pediatric psoriasis and association with cardiovascular and metabolic comorbidities: Systematic review and meta-analysis. Pediatr Dermatol. 2020; 37(4): 661–669.
  19. Takeshita J, Grewal S, Langan SM, et al. Psoriasis and comorbid diseases: Implications for management. J Am Acad Dermatol. 2017; 76(3): 393–403.
  20. Singh S, Young P, Armstrong AW. Relationship between psoriasis and metabolic syndrome: a systematic review. G Ital Dermatol Venereol. 2016; 151(6): 663–667.
  21. Bruins FM, Bronckers IM, Groenewoud HMM, et al. Association between quality of life and improvement in psoriasis severity and extent in pediatric patients. JAMA Dermatol. 2020; 156(1): 72–78.
  22. Caroppo F, Zacchino M, Milazzo E, et al. Quality of life in children with psoriasis: results from a monocentric study. Ital J Dermatol Venerol. 2021; 156(3): 374–377.
  23. Salman A, Yucelten AD, Sarac E, et al. Impact of psoriasis in the quality of life of children, adolescents and their families: a cross-sectional study. An Bras Dermatol. 2018; 93(6): 819–823.
  24. Matterne U, Apfelbacher C. Peer-relationship-problems account for quality of life impairments in pediatric psoriasis. J Psychosom Res. 2016; 84: 31–36.
  25. Tollefson MM, Finnie DM, Schoch JJ, et al. Impact of childhood psoriasis on parents of affected children. J Am Acad Dermatol. 2017; 76(2): 286–289.e5.
  26. Sampogna F, Finlay AY, Salek SS, et al. European Academy of Dermatology and Venereology TaskForce on Quality of Life. Measuring the impact of dermatological conditions on family and caregivers: a review of dermatology-specific instruments. J Eur Acad Dermatol Venereol. 2017; 31(9): 1429–1439.
  27. Kim E, Fischer G. Relationship between PASI and FDLQI in paediatric psoriasis, and treatments used in daily clinical practice. Australas J Dermatol. 2021; 62(2): 190–194.
  28. Pickett K, Frampton G, Loveman E. Education to improve quality of life of people with chronic inflammatory skin conditions: a systematic review of the evidence. Br J Dermatol. 2016; 174(6): 1228–1241.
  29. de Moll EH, Chang MWu, Strober B. Psoriasis in adults and children: kids are not just little people. Clin Dermatol. 2016; 34(6): 717–723.
  30. Ibrahim S, Amer A, Nofal H, et al. Practical compendium for psoriasis management. Dermatol Ther. 2020; 33(2): e13243.
  31. D'Adamio S, Silvaggio D, Massaro A, et al. Pharmacotherapeutic management of psoriasis in adolescents and children. Expert Opin Pharmacother. 2019; 20(14): 1777–1785.
  32. Tollefson M, Siegel D. Advancing paediatric psoriasis treatment options for children. Br J Dermatol. 2017; 177(6): 1470–1471.
  33. Debbaneh M, Millsop JW, Bhatia BK, et al. Diet and psoriasis, part I: Impact of weight loss interventions. J Am Acad Dermatol. 2014; 71(1): 133–140.
  34. Crall CS, Rork JF, Delano S, et al. Phototherapy in children: considerations and indications. Clin Dermatol. 2016; 34(5): 633–639.
  35. van Geel MJ, Mul K, de Jager MEA, et al. Systemic treatments in paediatric psoriasis: a systematic evidence-based update. J Eur Acad Dermatol Venereol. 2015; 29(3): 425–437.
  36. Subedi S, Yu Q, Chen Z, et al. Management of pediatric psoriasis with acitretin: A review. Dermatol Ther. 2018; 31(1).
  37. Bronckers IM, Paller AS, West DP, et al. Psoriasis Investigator Group, the Pediatric Dermatology Research Alliance, and the European Working Group on Pediatric Psoriasis. A comparison of psoriasis severity in pediatric patients treated with methotrexate vs biologic agents. JAMA Dermatol. 2020; 156(4): 384–392.
  38. Lansang P, Bergman JN, Fiorillo L, et al. Management of pediatric plaque psoriasis using biologics. J Am Acad Dermatol. 2020; 82(1): 213–221.
  39. Charbit L, Mahé E, Phan A, et al. Groupe de Recherche de la Société Française de Dermatologie Pédiatrique. Systemic treatments in childhood psoriasis: a French multicentre study on 154 children. Br J Dermatol. 2016; 174(5): 1118–1121.
  40. Lavaud J, Mahé E. Proactive treatment in childhood psoriasis. Ann Dermatol Venereol. 2020; 147(1): 29–35.

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