Limited Options for Pediatric Psoriasis Treatment

According to a recent review, psoriasis is not well recognized and treated among pediatric patients. Psoriasis is a chronic inflammatory disease that leads to skin manifestations. It is immune-mediated, but there are few medications approved for pediatric patients with psoriasis. Onset of psoriasis in childhood has been estimated to occur in 1/3 of cases, but underrecognition suggests a higher prevalence. Some clinical features are more subtle in children than adults, resulting in a misdiagnosis of atopic dermatitis. Recognizing psoriasis in children is crucial to anticipating similar physical and psychological burdens to those that affect adults, including streptococcal carriage, obesity, psoriatic arthritis, Crohn’s disease, rheumatoid arthritis, vitiligo, uveitis, anxiety, and depression.

Investigators used a series of PubMed searches to discern articles pertaining to pediatric psoriasis, discussing topics such as epidemiology, treatment efficacy and safety, disease characteristics, biologics, topicals, systemics, and access to care.

The selected articles demonstrated that it can be difficult to clinically diagnose psoriasis, and that patients often have trouble getting treatment. The medications which have been approved are often for adults and are not proven safe and efficient for pediatric use. This leaves pediatric patients with limited options for psoriasis treatment.

“Pediatric psoriasis is likely underrecognized and may be undertreated. Clinicians should balance relative risks with potential benefits when recommending the most effective treatment needed to improve psoriasis manifestations, comorbidities, and health-related quality of life in children,” investigators stated.

Though more trials are attempting to use biological agents for pediatric psoriasis, they may lead to concerns about applying these medications for pediatric use. Investigators concluded that clinicians must balance the risks and benefits for a treatment plan in pediatric patients.

Reference

1. Hebert AA, Browning J, Kwong PC, Duarte AM, Price HN, Siegfried E. Managing pediatric psoriasis: update on treatments and challenges-a review. J Dermatolog Treat. 2022;33(5):2433-2442. doi:10.1080/09546634.2022.2059051