Features of psoriasis in children

Abstract

The prevalence of psoriasis reaches about 3% of the global adult population and is twice as lower in the paediatric population. In children, as well as in adults, psoriasis is associated with several different concomitant pathologies: metabolic syndrome, depression, anxiety, arthritis, etc. However, the diagnosis of psoriasis in children and subsequent treatment is quite a difficult task. The clinical presentation in a pediatric patient differs from the symptoms of the disease in an adult. Psoriatic patches are usually thinner and with less severe desquamation, which is often accompanied by itching, and children are also characterized with unusual regions of rash localization, such as the periaucular or umbilical region. Psoriatic diaper rash is often misdiagnosed as diaper dermatitis. However, diaper psoriasis is the most common manifestation, seen in about 45% of cases in children under two years of age. In children, the presence of psoriasis is associated with an increased risk of metabolic syndrome and its components, and with higher rates of hyperlipidemia, even after weight management, in addition to an observed increased risk of depression and anxiety and a possible increased risk of arthritis and Crohn’s disease. The clinical presentation of pediatric psoriasis is diverse, and the diagnosis is most often made clinically. Auspitz’s sign, Koebner’s phenomenon, and Voronov’s ring might be of some help in clinical diagnosis. The treatment of psoriasis in children is based primarily on the same principles as in adults. However, few of the existing treatment options are approved for use in children and adolescents.