Better care for kids

| Chris Paoli

With one-third of all psoriasis cases beginning during the childhood years, it’s important to start treatment as early as possible to limit possible damage and avoid associated comorbidities. Fueled by the goal to improve treatment for younger patients living with psoriasis and psoriatic arthritis, the American Academy of Dermatology (AAD) and the National Psoriasis Foundation (NPF) released guidelines for pediatric psoriasis treatment in November.

Guidelines of Care for the Management and Treatment of Psoriasis in Pediatric Patients’ has been developed by board-certified dermatologists to outline best practices in treatment of younger patients, based on the latest scientific evidence and expert consensus. This is seen as a first-of-its-kind guide for medical professionals on how to care for the younger generation, and is only possible thanks to current psoriatic disease research, says dermatologist Kelly M. Cordoro, M.D., a member of the NPF medical board and a co-author of the guidelines.

“The knowledge gaps between adult and pediatric psoriasis are decreasing as clinicians and researchers focus on advancing our understanding of psoriasis in children,” says Cordoro. “Armed with a better understanding of this complex multisystem disease that begins in at least one-third of patients in the childhood years, we are also able to begin to close the management gaps.”

The guidelines can be used by medical professionals for overall management including measuring disease severity, assessing triggers, screening for comorbidities, and treating with topicals, phototherapy, systemic and biologic medications.

Due to their unique physiology, drug tolerances in younger individuals and the unique dynamic between a health care provider and child, it was important to develop these guidelines to tackle issues that typically aren’t addressed in an adult patient. One differing area is comorbidities.

Comorbidities and children

The latest guidelines outline unique physical comorbid issues in pediatric patients, including:

  • A link between diabetes and children. It is estimated that twice as many children living with psoriatic disease have a resistance to insulin, compared to children without psoriatic disease.
  • The link between obesity and psoriasis is greater for children than adults.
  • Kids with psoriatic disease are three to four times more likely to have inflammatory bowel disease than those without psoriasis.

Early intervention is key, and when treating for these and other associated comorbidities, medical professionals should follow the recommended guidelines for best results.

The emotional impact of the disease on a younger individual is also an important factor. The guide found that 65 percent of young patients experienced hardships relating to name-calling, bullying and shaming. The guide also found these hardships negatively affect physical activity in 15 to 30 percent of children with psoriasis. Therefore, it is recommended that pediatric patients be screened for depression and anxiety on a yearly basis.

Improving care

Since 2016, the NPF and AAD have been on a mission to educate medical professionals on how to treat psoriatic disease, across multiple topics. Last year also saw the release of guidelines on comorbidities, biologics and phototherapy, and this year will see the release of guidelines concerning non-biologic therapies and topicals.

It’s important to note that these guidelines are not a one size fits all treatment plan and should be taken as recommendations on how to best treat patients. Specific treatment plans will vary from patient to patient.

Pediatric guidelines

A full rundown of findings and suggestions for treating pediatric patients can be found here.  


Driving discovery, creating community

For more than 50 years, we’ve been driving efforts to cure psoriatic disease and improve the lives of those affected. But there’s still plenty to do! Learn how you can help our advocacy team shape the laws and policies that affect people with psoriasis and psoriatic arthritis – in your state and across the country. Help us raise funds to support research by joining Team NPF, where you can walk, run, cycle, play bingo or create your own fundraising event. If you or someone you love needs free, personalized support for living a healthier life with psoriatic disease, contact our Patient Navigation Center. And keep the National Psoriasis Foundation going strong by making a donation today. Together, we will find a cure.

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