Characteristics of pediatric psoriasis outlined
MedWire News: Children with psoriasis usually present with mild disease, predominantly of the plaque type, and boys are primarily affected, indicate the results of a Greek epidemiological study.
Prompted by the lack of epidemiological data for psoriasis in children, Christina Stefanaki and colleagues from Andreas Sygros Hospital in Athens collected information on 125 children diagnosed with psoriasis in the Pediatric Dermatology Unit of the hospital between 2005 and 2008.
These children represented 1.73% of the pediatric dermatology outpatients. The age of the children ranged from younger than 1 year to 13 years, and the peak age of onset was 9 to 10 years old.
The participants comprised 74 (59.2%) boys and 51 (40.8%) girls, at a male to female ratio of 1.4:1.
Only 16% of the patients had a positive family history of psoriasis and 50% of children presented within a month of the developing the disease.
The researchers report in the Journal of the European Academy of Dermatology and Venereology that plaque type psoriasis was the most prevalent type of psoriasis at presentation, affecting 56.8% of the children, followed by scalp involvement, affecting 33.6% of children.
The limbs were the most common site of involvement, as seen in 56% of children, followed by the body (47.2%), and scalp (48.0%).
Stefanaki and colleagues note that most (53.2%) of the children present with mild disease, affecting less than 5% of their skin, while 33.9% of children had 6-10% skin involvement, 9.7% had 11-20% involvement, and only 1.6% presented with severe disease affecting 21% of the skin or more.
The age at which a child developed psoriasis had no bearing on the severity of the disease, whereas disease severity was positively correlated with gender, in that boys had a greater percentage of skin involvement than girls.
Topical steroids were the most common form of treatment, used by 98.4% of children, followed by keratolytics (49.2%), calciportiol (48.4%), and topical tacrolimus and topical pimecrolimus (0.8% and 6.5%, respectively).
Systemic antibiotics were only given one child with guttate psoriasis, while another child with plaque psoriasis needed ultraviolet B phototherapy.
The researchers conclude: "Our study reflects the patterns of presentation of childhood psoriasis in sunny countries like Greece."
But they add that "the diversity in presentation of a rare disease such as childhood psoriasis can be considerable even in sunny countries like Greece."
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By Lucy Piper