Psoriasis
Psoriasis is one of those skin diseases that everyone’s heard about, but has never seen much of, and most people think is only for adults.
Who can get psoriasis?
It is much less common in children, but the risk increases as the child gets older. In adults about 2% of people have psoriasis of one form or another. People with relatives who have psoriasis or who have certain genes are more likely to develop it. Also, since it is related to the immune system it makes sense that childhood diseases, trauma, and even stress can affect the incidence of psoriasis.
What is psoriasis?
Psoriasis is a chronic disease caused by a problem with the immune system. It mostly causes parts of the skin to build up in different areas causing a rash, but can also cause nail changes and joint pain. There are a few different kinds of psoriasis.
*Plaque psoriasis is the most common type in children and adults. It consists of a large red plaque, or flat area of rash, that often has a silvery scale on it. This can occur anywhere, but can be more often on the scalp, elbows, knees, and lower back.
*Inverse psoriasis is also common in children. This is a smooth red rash in areas where skin touches skin – diaper area, armpits, etc. The typical silvery scale is not present in this type of psoriasis.
*Guttate psoriasis is more common in young people than adults. In this type of psoriasis, there are small red circular patches with silver scaling scattered on the trunk, and upper arms and legs.
*Pustular psoriasis is very rare, but can occur in children. This is when pustules (small blisters) start showing up on psoriatic plaques and on normal skin. It can cover a large portion of the body, but generally comes and goes.
*Erythrodermic psoriasis is the most rare, but also the most dangerous. In essence it acts like a burn, causing electrolyte imbalance, severe infection, and cardiovascular problems, and is a medical emergency.
Does psoriasis only affect the skin?
No. It can commonly also affect the nails, causing pitting, detachment from the nail bed, or discoloration. In a small portion of cases of plaque or guttate psoriasis children can develop juvenile psoriatic arthritis. It’s also been noted that children with psoriasis tend to have a higher risk of abnormal lipid numbers, obesity, and diabetes mellitus.
Also, because psoriasis can be a visible, lifelong issue, children can feel abnormal or different when around other children. Often other children-and even adults-will point, ask invasive questions, or act like there’s something wrong with your child just because of how their skin looks. If your child also has arthritis they may also be dealing with pain and decreased capability as well.
How is psoriasis diagnosed?
It is possible to diagnose it just by examination. If the diagnosis is unsure, then things like a family history, reaction of rash to other treatments, and if there were any illnesses or medications before the rash started. A skin biopsy can be taken if the diagnosis is still unsure.
Can it be treated?
Psoriasis is a chronic disease that often gets better and worse. Sometimes it gets worse for no particular reason, but there are things that can trigger a flare. Illnesses – especially strep, certain medications, stress, skin trauma, cold weather, drinking alcohol and smoking are all things that can cause a flare. Decreasing stress, eliminating smoke from the environment, and being careful about getting piercings are all things that can help. Timely counseling to and help deal with the disease itself, as well as the negative actions of others can also be a benefit for some children.
Emollients are recommended for all forms of psoriasis. These are products like petroleum jelly and aquaphor. They can help keep the skin moist so it doesn’t crack.
The next line of treatment is other topical products. Steroid creams are often used as well as other types of medicated creams. There are certain medicated shampoos that are also used.
UV therapy has been shown to be helpful in certain cases, and while also using some oral or topical therapy.
Oral therapy is mainly used when the psoriasis is causing joint problems, or when the skin is very bad. They can work very well, but all of them have side effects that can be fairly severe, especially if not carefully monitored.
Finally, even if a treatment works initially, it can stop working so well after a while. So make sure you keep in contact with your pediatrician or dermatologist to make sure you’re getting the treatment that’s best for your child at the time.
Bottom line.
Psoriasis is a chronic disease that has a wide range of effects on children. If your child has psoriasis, get the treatment they need, but remember it is a chronic disease that will get better and worse.
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