Childhood psoriasis: A clinical review of 1262 cases

Our aim was to describe the types of psoriasis seen in a large series of pa tients presenting to a tertiary referral pediatric dermatology department u sing a classification system combining conventional terminology and additio nal categories based on the site and characteristics of the rash. A total o f 1262 patients seen consecutively in the dermatology department of the Roy al Alexandra Hospital for Children, Sydney, Australia, between 1981 and 199 5 are described and classified according to the pattern of psoriasis at the time of presentation. Additional information recorded included family hist ory, facial involvement, and history of a psoriatic type of diaper rash in infancy. The ages of the children ranged from 1 month to 15 years. There wa s an equal gender distribution and a high rate of positive family history a t 71%. Twenty-six percent of children had a history of a psoriatic diaper r ash and facial involvement occurred in 38% of children. Plaque psoriasis wa s the most common type overall, affecting 430 patients (34%). Three hundred forty-five children were less than 2 years of age, and this is the largest series of children with psoriasis in this age group presented to date. An entity defined by us as psoriatic diaper rash with dissemination was the mo st common type of psoriasis in the less than 2-year age group, affecting 15 5 (45%) patients. This large series offers information on the manifestation s of psoriasis in childhood, but is particularly useful in examining the pr eviously less well-described infant age group. The classification used is p roposed as a practical way to describe psoriasis in children, particularly with respect to future descriptive studies.