Efficacy and safety of treatments for childhood psoriasis: A systematic literature review

Background: Evidence-based recommendations for therapeutic decision making in childhood psoriasis are lacking. Objectives: We sought to systematically review all available literature concerning treatment efficacy and safety in childhood psoriasis and to propose a recommendation for topical and systemic treatment of childhood psoriasis. Methods: Databases searched were PubMed, EMBASE, and the Cochrane Controlled Clinical Trial Register. All studies reporting on efficacy and safety of all treatment options in childhood psoriasis were obtained and a level of evidence was determined. Results: Literature search revealed 2649 studies, of which 64 studies met the inclusion criteria. The majority of topical and systemic therapies given in childhood psoriasis are efficacious. Short-term side effects were usually mild; long-term side effects were not described. Limitations: Most conclusions formulated are not based on randomized controlled trials. Conclusions: A rough summary of the proposed algorithm is as follows: first, calcipotriene with/without topical corticosteroids, followed by dithranol. Methotrexate is considered to be the systemic treatment of choice. (J Am Acad Dermatol 2010;62:1013-30.)