Tuesday, December 3, 2013

Psoriasis and Children


The vast majority of psoriasis sufferers are adults but a few unlucky children come down with the disease as well. Some of them also get psoriatic arthritis, a form of arthritis associated with the skin rash of psoriasis. It is extremely rare to get psoriasis as a baby unless there is a strong family history with many family members having psoriasis. In cases where psoriasis occurs in babies, it often occurs in the diaper area and is well demarcated, with a scaly rash on a red skin base.

Most children who get psoriasis get it between the ages of 5 and 10. The most common type of psoriasis in this age group is plaque-type psoriasis, which affects the child's knees, elbows and lower back. Children can also get scalp psoriasis, with involvement of the face and the groin, armpit and behind the knees. It is also relatively more common to get guttate psoriasis as a child, especially in the young teen years. This kind of psoriasis often follows a strep throat infection and appears like multiple one centimeter lesions all over the trunk, upper and lower limbs and scalp. This form of psoriasis often clears spontaneously but it may take many weeks or months before it does so.

Children get psoriasis the same way adults do. Psoriasis is hereditary for the most part and about thirty percent of all children with psoriasis have a parent who has the gene. Fifty percent of those with two parents with the disease stand a chance of getting psoriasis. One still needs a trigger in order to cause the disease to occur and that trigger can be stress, an illness or a skin injury. Even a scratch or a bug bite can cause the skin to break out in psoriasis. Puberty can be a common trigger for the advent of psoriatic lesions.

The treatment for childhood psoriasis can be a bit different from treatment for adult psoriasis. Doctors try to avoid strong treatments that can lead to skin cancer or damage to the liver or kidneys. Moisturizers and emollients are used quite frequently to get the scales off the skin and soften the base of the psoriatic lesions. Parents can put oils in the bath and apply creams, ointments or lotions in order to soften the skin. Some kids get better just with this form of treatment. Others will need coal tar preparations, applied at night because the treatment smells bad and needs to be washed off the skin in the morning so it doesn't stain the clothing.

In more serious cases, corticosteroid cream or creams containing vitamin D analogues are used to break down the inflammation and lighten up the redness and scaling of the skin. Other doctors may recommend light therapy using UVB or UVA light. The major side effect is burning of the skin and a risk of skin cancer later in life but it is a therapy that works really well for more serious cases of psoriasis.

Some important points to consider: A child with psoriasis should still get immunizations at the same rate as other kids but the site of the injection can become an area of psoriasis. Children with psoriasis should lead as normal a life as possible and should be told that their condition isn't serious or contagious. Parents and children should talk with their doctor together about the possibilities for treatment. The child should wear comfortable cotton clothing and underwear to allow the skin areas to breathe, especially during a flare-up. Always have some moisturizer handy so as to be able to treat the itchy areas whenever they act up.

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