Childhood Psoriasis

Abstract

Although all clinical types seen in children as in adults, guttat and flexural psoriasis are more frequent and more severe forms like pustular and eritrodermic psoriasis are rare. Activated T cells and dendritic cells plays a key role in pathogenesis, and the presence of polygenetic and environmental impacts are known for many years in the emergence of the disease. Streptococcal infections, obesity, exposure to smoke at home and stress are detected as important risk factors. Comparing with adults plaque-type psoriasis lesions in childhood are more itchy, with finer, softer and less squamation. Erythroderma, arthropathy, localized and generalized forms of pustular psoriasis are quite rare in contrast to guttat psoriasis. Appropriately selected and regularly conducted topical treatment is sufficient to keep under control the disease in the majority of the patients. However, in the process of dynamic disease from time to time systemic therapies may be needed. Systemic therapy is often preferred for erythrodermic and pustular forms. However, systemic treatment may also involve severe plaque psoriasis. Ultraviolet, acitretin, methotrexate and etanercept are treatment options applied with success to date in children. (Turkderm 2011; 45 Suppl 2:127-32)