What Does Psoriasis Look Like in Children?

Psoriasis can begin at or shortly after birth but in most children it usually does not occur until school age. Usually a family history of the disorder is quite normal. When present in babies or infants, it normally starts in the diaper area (napkin psoriasis) and can spread elsewhere over the body. In children, psoriasis can develop as small, flat or raised, red, discrete areas that develop a thick, silvery scale. These small areas can join together to form raised, thick, scaling plaques. A sharp edge separating infected area from the normal skin. Common areas infected include the scalp, ears, elbows, knees, buttock crease, genitals and nails. The most common type of psoriasis in children is chronic plaque-type psoriasis, with raised, thick, scaling areas. It must be pointed out that Psoriatic arthritis is normally rare in children.

In up 33% in children, the first showing of psoriasis can be multiple, small, teardrop-shaped, scaling, raised lesions, known as guttate psoriasis. It is possible that children might pick up an infection of guttate psoriasis following a cold (upper respiratory infection), normally a bacterial infection of the throat (streptococci pharyngitis or "strep throat"). But occasionally, a bacterial infection (streptococci) of the rectum can lead to a spell of guttate psoriasis. Also, if the child is prone to tonsillitis, psoriasis could repeat itself with future cases of tonsillitis. Guttate psoriasis most commonly affects the back, abdomen, arms and legs. While a child might have a fever with a bacterial infection, it is not normal for children to have a fever with psoriasis.

In children, as with adults, psoriasis can start with an injury (Koebner's phenomenon). Psoriasis may occur along a scratch or appear after abrasions, cuts or insect bites. This information could be a helpful indication in diagnosing psoriasis.

Scalp Psoriasis is very common in children, scaling, raised lesions can be found either behind the ears and/or along the hairline, or the entire scalp. This can result in the shedding of white scales from the scalp, commonly mistaken for dandruff.

The genitals are also often affected in children., particularly babies and infants. The penis, groin, buttock crease and labia are common sites of infection. Fingernails and toenails can be affected, the nails may become pitted or rough, Lifting of the nail from the surrounding skin can also occur (onycholysis). Occasionally in children, all 20 nails may be involved.