Psoríase invertida infantil extensa - abordagem do manejo / An approach to the management of childhood extensive inverse psoriasis

Introdução: Entre as afecções dermatológicas imunomediadas a psoríase merece destaque, por representar cerca de 4% de todas as dermatoses em menores de 16 anos e acometer 3,5% de toda a população mundial. Apresenta diversas variantes clínicas e quanto mais precoce, mais grave tende a ser sua evolução. Na infância pode ser classificada em três grupos: psoríase infantil (doença autolimitada da infância), psoríase de início precoce (com persistência do quadro na idade adulta); e com acometimento articular. Relato: Paciente feminino com 10 anos de idade, queixa de aparecimento de placas eritêmato-descamativas pruriginosas há seis meses, que se iniciaram na cabeça e progrediram para as áreas flexurais, axilas e região inguinal. A biópsia confirmou o diagnóstico de psoríase. Foi iniciado o uso de clobetasol tópico para as lesões da pele com melhora dos focos. Seis meses depois apresentou piora do quadro, apresentando placas eritêmato-descamativas grandes nas regiões cervical, lateral do tronco e inguinal, porém sem acometimento articular ou ungueal. Resultados: Novamente medicada, desta vez, com a combinação de calcipotriol e ácido salicílico, uma vez ao dia, e betametasona, duas aplicações ao dia, com melhora significativa das lesões em quatro semanas. Conclusão: Apesar das diferenças entre a psoríase infantil e do adulto, a terapia utilizada no tratamento de ambas é a mesma, tendo apenas sua dose e potência ajustadas para tratamento pediátrico. Na grande maioria das vezes, a doença pode ser tratada efetivamente com medicação tópica...

Demographic and clinical profile of childhood psoriasis in a tertiary hospital: A six-year retrospective study

BACKGROUND: There is a paucity of local literature focusing on childhood psoriasis.OBJECTIVE: To describe the clinico-demographic profile of childhood psoriasis patients seen in the Philippine General Hospital (PGH) dermatology outpatient clinic.METHODS: Records of psoriasis patients aged 18 and below seen at the PGH dermatology outpatient clinic from January 2004 to December 2009 were reviewed.RESULTS: A female preponderance of childhood psoriasis with a male-to-female gender ratio of 1:2 was found. Mean age of onset was earlier in males (7.89 ± 5.77) than females (12.27 ± 5.35) (p-value = 0.026). Chronic plaque type psoriasis was most frequent (71.43%), followed by guttate (16.67%), erythrodermic (7%) and pustular psoriasis (5%). The scalp (61.9%) was the most common overall initial site of onset followed by the trunk (50%). Nail involvement was seen in 29% while 11.9% had joint involvement. Topical steroid application was the most commonly used treatment.CONCLUSION: This retrospective study reveals a female predominance of childhood psoriasis in the Filipino population. The most common overall initial site of onset is the scalp and the most frequent psoriasis phenotype overall is plaque-type psoriasis.

A Clinical Study of Childhood and Adolescent Psoriasis / 대한피부과학회지

BACKGROUND: Few clinical studies are available on childhood and adolescent psoriasis in Korea. OBJECTIVE: The purpose of this study was to analyze clinical features of childhood and adolescent psoriasis in a referral center in Korea. METHODS: We performed retrospective medical record-based analyses for 255 psoriasis patients younger than 16 years of age at the time of diagnosis at our center from March 2001 to July 2010. Age, sex, onset age, familial history, site of involvement, type of psoriasis, nail involvement, initial PASI score, and treatment modality were analyzed. RESULTS: There was no sexual predominance; mean age of onset was 8.85 years; 17.25% of patients had a familial history. Upper extremities, lower extremities, trunk, scalp and face were the most commonly involved sites in sequence. Guttate psoriasis (58.90%) was the most common type of psoriasis. Nail involvement was observed in 11.11% of patients. The mean initial PASI score at the time of diagnosis was 7.9. The most common treatment was topical steroids and topical vitamin D in combination. CONCLUSION: Childhood and adolescent psoriasis is not an uncommon disease. A larger scale epidemiological study is needed.