Epidemiology of childhood psoriasis: a study of 419 patients from northern India.
ABSTRACT We undertook this study in order to determine the pattern and prevalence of childhood psoriasis in northern India and to highlight the differences and similarities with previous studies.
In this retrospective epidemiologic study, the data from 419 children (less than 14 years of age) with psoriasis registered at the Psoriasis Clinic between January 1990 and December 2002 were included.
The 419 children registered at the Psoriasis Clinic constituted 0.3% of the dermatology outpatients and 12.5% of the total psoriasis patients seen over a period of 13 years in the department. There were 219 (52.2%) boys and 200 (47.7%) girls, with a male to female ratio of 1.09 : 1. The age of onset ranged from 4 days to 14 years. The mean age of onset was 8.1 +/- 2.1 years in boys and 9.3 +/- 2.3 years in girls. The peak age of onset in boys was in the 6-10-year age group, whereas the majority of girls showed an onset of psoriasis between the ages of 10 and 14 years. A positive family history was present in only 19 (4.5%) patients. The extensors of the legs were the most common initial site affected [105 (25%) cases], followed by the scalp [87 (20.7%)]. Classical plaque psoriasis was the most frequent clinical presentation [254 (60.6%) patients], followed by plantar psoriasis [54 (12.8%)]. Nail involvement was observed in 130 (31%) cases. All types of nail changes described in psoriasis were seen in these patients. Pitting was the most common nail change, followed by ridging and discoloration. Five children (1.1%) (three girls and two boys) had psoriatic arthropathy. Precipitating factors that brought about the onset of the disease or were associated with exacerbation could be recalled in only 28 (6.6%) patients. Koebnerization was observed in 27.9% of patients. Pruritus was the most frequent symptom, reported by 365 (87.1%) children. Twenty-seven (6.4%) children had other concurrent mucocutaneous diseases (vitiligo, pityriasis alba, alopecia areata, ichthyosis vulgaris, halo nevus, aphthous stomatitis, urticaria, pityriasis versicolor, nummular eczema, salmon patch, and verrucous epidermal nevus). Eighteen children had systemic disorders, including seizures, bronchial asthma, mitral regurgitation, scleroderma, Down's syndrome, high arched palate, cholelithiasis, anterior mongoloid slant, and prognathism; however, these conditions were possibly chance findings only and no correlation with the age of onset or severity of the disease was found.
Our findings differ from those of previous studies in showing a delayed onset, equal sex distribution, less frequent facial involvement, uncommon guttate lesions, more frequent involvement of the soles, and a less frequent history of familial occurrence.
Article: Childhood psoriasis[Show abstract] [Hide abstract]
ABSTRACT: Psoriasis (Ps) is a T-cell-mediated chronic inflammatory disorder of the skin seen in about 3.5% of the population. One-third of Ps cases in dermatology center are pediatric patients. Pediatric Ps consists broadly of three age groups of psoriatic patients: infantile Ps, a self-limited disease of infancy, Ps with early onset and pediatric Ps with psoriatic arthritis. Timely diagnosis and appropriate management can not only arrest progression but also minimize the psychosocial burden imposed by this illness thereby averting disfiguring states and its evolution into a metabolic syndrome requiring extensive treatment. This review will cover almost all aspects of pediatric Ps including the rare clinical form congenital erythrodermic Ps and present the latest update especially on the etiopathogenesis and treatment options.Expert Review of Dermatology 01/2014; 8(5).
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ABSTRACT: Background Childhood and adolescent psoriasis is not an uncommon disease, but epidemiological information from a large series of studies is still lacking.Objective Our purpose was to present the demographics, clinical features, and outcome of psoriasis appearing in Greek patients from infants up to adolescents.Methods We conducted a retrospective analysis of 842 children and adolescents who diagnosed with psoriasis over a period of twenty years.ResultsThe mean age of psoriasis onset was 7.33 years, and the sex distribution was equal between boys and girls. Plaque-type psoriasis was the most frequent type (82.1%), followed by perianal, inverse, and guttate. The limbs and the scalp were the main body areas affected. The affected body surface area (BSA) was more than 10% in only 1.7% of patients, and the overall disease manifestations were considered to be mild. Psoriatic nails were detected in 11.8% of patients, while psoriatic arthritis in only six (0.7%) patients. An additional autoimmune disease was present in 3.8% of patients, and 16.7% had a positive family history for first-degree relatives. The main choice of therapy was topical treatment.Conclusion Gender distribution, type of psoriasis, and body area affection is almost the same as in adults. Most of the patients presented with mild disease of little extent, possibly indicating the favorable effect of sun in a Mediterranean country. The most often prescribed treatment for the majority of patients was topical.International journal of dermatology 04/2014; · 1.18 Impact Factor
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ABSTRACT: Psoriasis is a chronic inflammatory cutaneous disorder affecting 2%-4% of the world's population. The prevalence of the disease in childhood and adolescence ranges between 0.5% and 2%. The management of psoriasis in adolescence is an intriguing and complicated task. Given the paucity of officially approved therapies, the very limited evidence-based data from randomized controlled trials, and the absence of standardized guidelines, physicians must rely on published experience from case reports both from the field of dermatology as well as from the application of these drugs for other pediatric conditions coming from the disciplines of rheumatology, gastroenterology, and oncology. Psoriatic adolescents deal with a potentially disfiguring and lifelong disease that could permanently impair their psychological development. It must be clarified to them that psoriasis does not have a permanent cure, and therefore the main goal of treatments is to establish disease control and prolonged periods between flares. The majority of adolescents suffer from mild psoriasis, and thus they are treated basically with topical treatment modalities. Phototherapy is reserved for adolescents with mild-to-moderate plaque disease and/or guttate psoriasis when routine visits to specialized centers do not create practical problems. Systemic agents and biologics are administered to patients with moderate-to-severe plaque psoriasis, pustular psoriasis, or erythrodermic psoriasis.Adolescent Health, Medicine and Therapeutics 01/2014; 5:25-34.