All about psoriasis in children

In light of August being Psoriasis Awareness Month, we’re discussing treatment, causes, triggers, and management of this inflammatory disease common in children.

What is psoriasis?

Psoriasis is a skin disorder that causes itchy, dry areas. Up to 40% of children with psoriasis develop symptoms before the age of 16, and 10% develop it before the age of 10.

What Are the Types of Psoriasis?

In children, common types of psoriasis include:

1. Plaque psoriasis: This is the most common type of psoriasis in children. It causes plaques and silvery scales, usually on the knees, elbows, lower back, and scalp. They can be itchy and painful and may crack and bleed.
2. Guttate psoriasis: This type often shows up after an illness, especially strep throat. It causes small red spots, usually on the trunk, arms, and legs. Spots also can appear on the face, scalp, and ears.
3. Inverse psoriasis: This causes smooth, raw-looking patches of red skin that feel sore. The patches develop in places where skin touches skin, such as the armpits, buttocks, upper eyelids, groin and genitals.

Psoriasis symptoms in children

There are various forms of psoriasis, each with its own set of symptoms. The following are the most prevalent psoriasis symptoms:

• Elevated skin areas that are frequently red and coated with whitish-silver scales (and are commonly mistaken for nappy rash in infants)
• Scaly plaques on the scalp
• Itching, soreness, or a burning sensation in and around the affected areas of skin
• Thick, pitted fingernails
• Painful, stiff, swollen joints

What causes psoriasis?

The precise cause of psoriasis is unknown. However, specialists believe that the immune system, which battles infections and diseases, is involved. Overactive immune system cells cause skin cells to proliferate faster than the body can lose them, causing plaques to form on the skin.

A bacterial infection, such as strep throat, is frequently the first cause of psoriasis in children. Other children inherit certain genes from their parents that increase their chances of contracting it (about 40% of children with psoriasis have a family member who has it).

Obesity and certain medications, such as lithium, beta-blockers, or malaria treatments, might further increase a child’s risk of contracting the condition.

How is psoriasis diagnosed in children?

Your family doctor can typically identify if your child has psoriasis by carefully inspecting their skin, nails, or scalp. They may take a small skin sample and send it to a lab for further examination. They will also inquire about your family history and behaviours to determine how many risk factors your child has.

Treatment

To relieve itching, your child’s doctor would most likely prescribe an antihistamine (a type of medicine used to treat allergies). It’s also crucial to keep your skin hydrated. They might recommend petroleum jelly to keep moisture in. Salicylic acid is another option for thick, red skin patches, however, it should not be used on children under the age of six.

Other possible treatments include:

• Topical therapies
• Phototherapy
• Oral medications

How Can Parents Help?

For some children, psoriasis is just a minor inconvenience. For others, it is a difficult medical condition.

Whether your child’s psoriasis is mild or severe, learn about the condition together. Offer to help find a therapist or join a support group if that might help. Talk to your doctor or contact the Psoriasis Association South Africa for support.