Psoriasis in Children 儿童银屑病

Chronic plaque psoriasis is the most common clinical form of psoriasis in children, approximately one-third reported onset of disease during the first two decades of life and 10 percent reported onset prior to the age of 10 years [1]. Psoriasis is more frequent in older children than young children (picture A and C).

A population-based study in US found that the incidence of children psoriasis doubled between the periods of 1970 to 1974 and 1995 to 1999 [2]. The rising prevalence of obesity, a risk factor for psoriasis, may contribute to this finding [2].

A complex interplay of environmental and genetic factors contributes to risk for psoriasis. A family history of psoriasis is a common risk factor; in a multicenter study of 409 children with psoriasis, approximately 30 percent reported an immediate family member with psoriasis [3].

Scalp Sporiaisis

Scalp psoriasis is up to 79 percent in children [4]. Scalp psoriasis is more common in girls than boys, which may be secondary to the Koebner phenomenon (lesion development in sites of skin trauma) induced by frequent combing, brushing, or vigorous shampooing [4].

Well-demarcated, erythematous, scaly plaques are typical (picture A), although the plaques may also have a salmon-colored, greasy appearance similar to seborrheic dermatitis. While seborrheic dermatitis tends to remain within the hairline, psoriasis plaques often extend beyond the hairline to the upper forehead (picture A), pre- and postauricular skin, and nuchal areas.

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How is psoriasis treated? 

Treatments for psoriasis come in creams and ointments, pills, or injections. There is also a form of light therapy that can help with psoriasis. All conventional treatments for psoriasis work by slowing the growth of skin, suppressing the immune response that causes psoriasis, or both.

There are treatments that can relieve the symptoms of psoriasis. But the condition cannot be cured with those conventional immunosuppressants. For instance, steroids are the most often used immunosuppressants.

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Most people need to understand treatments before they figure out what works best. More and more research is being done to discover natural remedies for treating psoriasis. Evidence is growing to support the use of herbs to treat certain types of psoriasis. Herewith we present a child psoriasis successfully treated with herbal medicine.

 

Reference:

  1. Farber EM, Nall ML. The natural history of psoriasis in 5,600 patients. Dermatologica 1974; 148:1.
  2. Tollefson MM, Crowson CS, McEvoy MT, Maradit Kremers H. Incidence of psoriasis in children: a population-based study. J Am Acad Dermatol 2010; 62:979.
  3. Paller AS, Mercy K, Kwasny MJ, et al. Association of pediatric psoriasis severity with excess and central adiposity: an international cross-sectional study. JAMA Dermatol 2013; 149:166.
  4. Mercy K, Kwasny M, Cordoro KM, et al. Clinical manifestations of pediatric psoriasis: results of a multicenter study in the United States. Pediatr Dermatol 2013; 30:424.