Children and psoriasis

What is psoriasis?
Psoriasis is a common skin condition affecting 2-3% of the population of the United Kingdom and Ireland. Of these, about 10% of adults with psoriasis develop the condition before the age of 10 years.

What does it look like?
Psoriasis appears as raised red patches of skin covered with silvery scales – often called plaques. It is very simply a speeding up of the usual replacement processes of the skin. This process is the same wherever psoriasis occurs on the body.

Do babies get psoriasis?
It is exceedingly rare for babies to have psoriasis particularly if there is no history in the family. Rashes in the nappy area may be psoriasis or may be a straightforward nappy rash. Psoriasis in the nappy area will look red and shiny with little scaling, and it will be very clearly demarcated i.e. it will be clear where the psoriasis stops and regular skin begins.

How does psoriasis affect children?
The most common form of psoriasis in children is plaque psoriasis affecting the elbows, knees and lower back. The scalp can also be involved in children, along with the face and flexures (for example, the groin, armpit and behind the knees).
Guttate psoriasis is also more common in childhood and teenage years. This form of psoriasis often follows a throat infection and appears as a generalised rash of small, scaly patches up to 1cm in diameter. The patches often affect the trunk, limbs and occasionally scalp. Guttate psoriasis generally clears well, but this may take several weeks or months.

Why has my child got psoriasis?
Psoriasis is not yet a fully understood condition, however, around 30% of people with psoriasis have a family history of the condition, and certain genes have been identified as being linked to psoriasis. A trigger is still required for psoriasis to develop, regardless of a family link. Triggers include injury to the skin (a simple scratch or insect bite), the streptococcal sore throat, stress and emotional upset and puberty.

What treatments are available for children?
Moisturisers and emollients are vital in the treatment of psoriasis – they will help soothe, smooth and hydrate your child’s skin in order to keep it in good condition and help the active treatment creams and ointments work more effectively. There are lots of emollients and moisturisers to choose, from oils to put in the bath, to creams, lotions and ointments to put directly onto the skin. For some children, moisturisers and emollients are all they will require to manage their psoriasis. Other more active creams and ointments include coal tar based applications, vitamin D analogues, topical steroid treatments and dithranol.
If your child’s psoriasis becomes more severe, they may be referred to a dermatologist. Dermatologists are able to offer other stronger forms of treatment such as ultraviolet light (UV) therapy and tablets

Immunisations
All the usual immunisation procedures may be safely given but it is worth remembering that a patch of psoriasis may come up at any site where the skin has been injured e.g. following immunisation with BCG.

Helpful Hints
· Children should lead as normal a life as possible – psoriasis is only a part of who they are.
· Parents and children may have different views about treatments – it is important to talk this through and respect their views.
· Cotton clothing, underwear and bedding may be more comfortable for your child during a psoriasis flare.
· Inform your child’s teacher in case they need time off school to attend doctors appointments, or help in explaining the condition to their classmates – that it is not contagious.
· Establish a treatment routine, but don’t let it rule your or your child’s life.
· Have a small pot of moisturiser that will fit in a handbag or school bag to use when away from home – this can help soothe itchy skin that may be bothersome in the daytime.

This is a brief overview of psoriasis in children, for copies of our Parent’s Guide, PsoKids (an interactive CD-ROM for children aged between 5 and 11 years) or PsoTeen (information specifically for teenagers), please contact the office