Childhood psoriasis

Psoriasis is a common skin disease in infants, children, and adolescents. A review of the clinical, epidemiologic, genetic, and therapeutic aspects of childhood psoriasis is presented. Population studies indicate that the fir st signs of psoriatic lesions occur in the pediatric age group, birth to 18 years of age, and that both genetic and environmental factors interact to precipitate the development of psoriasis. Koebner reactions are the result of external or internal triggering factors, such as physical injury to the skin, low humidity and certain drugs. The most frequently observed variant of psoriasis is the plaque type, followed by guttate psoriasis, and juvenil e psoriatic arthritis. Pustular psoriasis and erythrodermic psoriasis are r are forms of the disease, but are seen in children from infancy to adolesce nce. The scalp is the most frequently affected site of involvement in pedia tric psoriasis, followed by the appearance of lesions on the extensor surfa ces of the extremities trunk, and nails. Although not common in adult psori asis, the face and ears are often involved. Topical medications such as cor ticosteroids, calcipotriol, coal tar preparations, anthralin formulations, and ultraviolet B are recommended in monotherapy or in combination therapy whereas psoralen plus ultraviolet A, methotrexate, and retinoids should onl y be administered in crisis situations. The treatment objectives in childho od psoriasis are to preserve skin surfaces, to afford physical relief from the disease, and to employ treatments that do not endanger the health or fu ture development of the child.