This article is more than 5 years old. Information may no longer be current.
Challenges of pediatric psoriasis include better standards of care
Click Here to Manage Email Alerts
A recent clinical review addressing treatment of pediatric psoriasis identified several gaps in the current standard of care, including differences in symptom appearance compared with adult patients and the risk for long-term comorbidities.
“As guidelines are lacking and most (systemic) treatments are not approved for use in children, treatment of pediatric psoriasis remains a challenge,” Amy S. Paller, MD, chair of the department of dermatology at the Northwestern University Feinberg School of Medicine, and colleagues wrote. “Because of the burden of disease and the associated comorbidities, early diagnosis and management in children are essential.”
Amy S. Paller
The researchers reviewed epidemiological features of pediatric psoriasis, noting that incidence has more than doubled from 1970 to 2000. Review results also showed that approximately 30% of psoriasis patients have a direct family member affected by psoriasis, which is more likely in pediatric patients than adult patients.
While most diagnoses of psoriasis rely on clinical features, pediatric patients can present with lesions that differ in morphology and distribution than adult patients. Affected children may have erythematous plaques with overlaying scales that are thinner and smaller than those typically found in adult patients. Psoriasis legions also develop more often on the face and flexural areas in children.
Other gaps in the treatment of pediatric psoriasis identified by the researchers included:
- a lack of international standard-of-care guidelines;
- the use of anecdotal experience and the adult standard of care to treat pediatric patients;
- pain and social stress related to the condition greatly impact quality of life; and,
- an association between pediatric psoriasis and other morbidities such as hyperlipidemia, obesity, hypertension, diabetes mellitus and rheumatoid arthritis.
“The evidence on treatment efficacy and safety is still limited, and long-term data in pediatric patients are lacking,” Paller and colleagues wrote. “A prospective, multicenter, international registry is needed to evaluate these treatments in a standardized manner and ultimately to develop international guidelines on pediatric psoriasis.” – by David Costill
Disclosure: Paller reports being an investigator without honorarium for Abbvie, Amgen and Stiefel/GlaxoSmithKline. She also reports receiving honorarium and consultant fees from AbbVie and Celgene.
Click Here to Manage Email Alerts