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Quick reference medical handouts used by Pediatric offices


Psoriasis in Children




Psoriasis ("sor-eye-ah-sus") is a common skin condition that appears as an irritating, raised red patches of skin covered with silvery scales. The rash occurs on any part of the body, although the knees, elbows and scalp are the most common sites. Psoriasis is not contagious from one person to another, nor can it be transferred from one part of the body to another.

The exact cause of psoriasis remains a mystery. It is felt that a child who develops psoriasis was probably born with a disposition for the condition from his or her parents.  Having one parent with psoriasis will increase the chance of a child developing the condition. If both parents have it there is an even greater chance the youngster will develop the condition earlier in life. A virus or infection, certain medications, and both physical and emotional stress then trigger the immune system to produce the rash. A common scenario is one in which a child gets a sore throat and then two or three weeks later develops the characteristic red, scaly rash of psoriasis on his body. Psoriasis does not usually begin in children before the age of four or five. Children with this condition may receive all the usual childhood immunizations, but it is worth knowing that a patch of psoriasis may appear at any site where the skin has been “injured.

Under the microscope, psoriasis appears to be acceleration of the normal process of skin replacement. Human skin sheds itself every 3-4 weeks, with new skin replacing the constant (invisible) shedding of dead cells. Individuals with psoriasis seem to shed their skin much quicker and in an unpredictable manner, with live skin cells reaching the surface and mixing with the dead skin cells in layers.

Since psoriasis is a reaction of the immune system, it is not contagious. However, since the rash can look quite ugly, it is important that the child is able to handle such questions from other children such as It can look quite ugly so it you may want to talk to your child about how to handle questions such as, 'Ugh, what's that? Will I get it?’ If your child's psoriasis is severe, contact the youngster’s teacher to explain the condition. Ask the teacher to talk to the class about the rash so that your child doesn't have to face teasing, or embarrassing questions about their appearance.


Treatment tips include:

  • The child should lead a life as normal as possible. However games and physical education may occasionally have to be missed when the lesions are at their worst.
  • Cotton underwear, sleepwear, etc., is more comfortable, especially in warm summer weather.
  • Care should be taken that the child does not suffer sunburn
  • For very special occasions, cover-up creams can be used to camouflage any lesions that show. Several companies manufacture them and they come in quite a range of tones to match the skin.
  • Tender loving care from family and friends will help the child cope with many of the problems connected with his or her psoriasis.
  • Your child’s doctor will probably begin treatment with a topical steroid usually in the form of hydrocortisone cream. This will soothe the redness and the itching, In addition, creams, are recommended to thin out the thick scaly part of the rash. For psoriasis on the scalp, the same medications in solution form will be tried.
  • It is important to keep the skin moist by giving your child regular baths in lukewarm water, without a lot of soap. Use lots of thick moisturizer after the bath, to seal in the water that was absorbed into the skin. Basically, parents will want to keep their child's skin well hydrated since outbreaks are more common when the skin is dry and rough.
  • Sometimes psoriasis clears up with a little exposure to the sun. (You may already notice that your child's skin improves during the summer.) Of course, more time in the sun means an increased risk of sunburn so you'll need to take it very slowly. Start by exposing the rash to the midday sun for about five minutes without sun block and gradually add a few minutes each day for a week. A word of warning: if your child is really pale or sensitive to the sun, this may not be the best option. Talk to your doctor to get her opinion.


The scales of psoriasis should improve almost immediately but it may take 2 to 6 weeks for the affected areas of the child’s skin to return to a more normal thickness, and the redness may last several months. While psoriasis will improve, it may not completely go away. Sometimes, certain scaly spots will get better at the same time that other spots get worse.

After you've been using a certain type of medicine for a while, your child’s psoriasis may "get used to" the treatment. If this happens, the medication may not be as effective as it once was, necessitating a change in treatment.

The good news is that when psoriasis starts in childhood, there's a good chance that it will go away or become milder as your child is older. But the condition is unpredictable. Unfortunately there is no way of telling when an outbreak will start, how long it will last, or when the condition might be gone for good.

 

  

posted 12-8-03 on Kidsgrowth.com

 

As a reminder, this information should not be relied on as medical advice and is not intended to replace the advice of your child’s pediatrician. Please read our full disclaimer.

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