Management of psoriasis in children.

Fifteen per cent of psoriasis patients experience onset of their disease before 10 years of age. Thus, psoriasis is a common childhood disease that requires comprehensive management. The quality of rapport with the child and parents is essential to the success of the treatment of this chronic condition. Adequate information on treatment objectives and modalities should be provided. The family environment and potential role of psychological factors should be evaluated. Special care should be given to weighing the advantages and disadvantages of available treatments. In most cases the disease is relatively mild and aggressive treatments are not warranted. Limited forms can be treated by topical preparations, such as calcipotriol, corticosteroids, and emollients. The rules and duration of application should be followed scrupulously. In infants with psoriasis of the diaper areay, the Koebner response is perpetuated by the use of diapers, which should be discontinued for as long as necessary. Oral antimicrobial therapy can be effective in guttate psoriasis, a condition often triggered by streptococcal pharyngitis. A few children develop severe extensive psoriasis vulgaris or pustular erythrodermic psoriasis. These patients requires aggressive therapy, especially with oral retinoids.