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2016 ; 6
(2
): 125-42
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Systemic Treatment of Pediatric Psoriasis: A Review
#MMPMID27085539
Napolitano M
; Megna M
; Balato A
; Ayala F
; Lembo S
; Villani A
; Balato N
Dermatol Ther (Heidelb)
2016[Jun]; 6
(2
): 125-42
PMID27085539
show ga
Psoriasis is a chronic, immune-mediated, inflammatory skin disease, affecting
1-3% of the white population. Although the existence of two psoriasis incidence
peaks has been suggested (one in adolescence before 20 years of age and another
in adulthood), its onset may occur at any age, including childhood and
adolescence, in which the incidence is now estimated at 40.8 per 100,000. As for
adult psoriasis, pediatric psoriasis has recently been associated with obesity,
metabolic syndrome, increased waist circumference percentiles and metabolic
laboratory abnormalities, warranting early monitoring and lifestyle
modifications. In addition, due to psoriasis' chronic nature and frequently
occurring relapses, psoriatic patients tend to have an impaired quality of life,
often requiring long-term treatment. Therefore, education of both pediatric
patients and their parents is essential to successful and safe disease
management. Given the lack of officially approved therapies, the very limited
evidence-based data from randomized controlled trials, and the absence of
standardized guidelines, to date, pediatric psoriasis treatment is primarily
based on published case reports, case series, guidelines for adult psoriasis,
expert opinions and experience with these drugs in other pediatric disorders
coming from the disciplines of rheumatology, gastroenterology and oncology. This
review focuses on the use of systemic treatments in pediatric psoriasis and their
specific features, analyzing the few literature evidences available, expanding
the treatment repertoire and guiding dermatologists in better managing of
recalcitrant pediatric psoriasis.
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