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SYMPOSIUM
Year : 2012  |  Volume : 13  |  Issue : 1  |  Page : 2

My view point - Psoriasis in children


Department of Pediatric Dermatology, B.J. Wadia Hospital for Children, Parel, Mumbai, Maharashtra, India

Date of Web Publication23-Oct-2012

Correspondence Address:
Deepak Parikh
Department of Pediatric Dermatology, B.J. Wadia Hospital for Children, Parel, Mumbai, Maharashtra
India
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Source of Support: None, Conflict of Interest: None


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How to cite this article:
Parikh D. My view point - Psoriasis in children. Indian J Paediatr Dermatol 2012;13:2

How to cite this URL:
Parikh D. My view point - Psoriasis in children. Indian J Paediatr Dermatol [serial online] 2012 [cited 2020 Jul 6];13:2. Available from: http://www.ijpd.in/text.asp?2012/13/1/2/102797

Psoriasis is not uncommon in pediatric practice.

Psoriasis in an infants presents more often in flexural areas. I find candidial diaper dermatitis with psoriasiform id eruption, which is often misdiagnosed as psoriasis. Most of the time emollients are sufficient in this age group.

Psoriasis in childhood phase can involve the face. It can present with asymptomatic, isolated, well-defined and non-scaly plaque on eye-lids. Palmo-planter psoriasis is one of the difficult clinical presentations. Children want to play and this leads to more friction and exacerbation. Severe palmar lesions with fissures, make studies very difficult. I prefer to use for small localized patch initially mid-potency steroid. I even use topical steroid under occlusion in palmo-planter lesions for short period of time. (10-14 days) Tacrolimus is useful on facial lesion. Though topical Vitamin D3 analogues are supposed to be useful, I find them to be irritating in sensitive areas.

Wide spread psoriasis is a big challenge. Parents are apprehensive and are always very worried about long term prognosis. I find children with wide spread psoriasis do get controlled, but do get intermittent flare ups - show few plaques. I have used Cyclosporine and Methotrexate in children with psoriasis. Cyclosporine works fast, however the disease tends to relapse within 4-6 weeks, on discontinuing cyclosporine. While methotrexate acts by 4-6 weeks, and gives a long term remission. NB-UVB is a first line therapy, but often parents find it difficult to implement. Acitretin is useful in wide spread guttate lesions. However, I do not find it to be useful in wide spread plaque type lesions.




 

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