Childhood psoriasis: Analytic retrospective study in Saudi patients

Abstract

Psoriasis is a genetically determined chronic inflammatory and immunologically mediated disease. At an early age, the presentation of psoriasis may be atypical. Among all types of childhood psoriasis, plaque type is the most common. In this article, we report our data analysis on the main clinical aspects of childhood psoriasis, its onset, risk factors, demographics and therapeutic options. A total of 36 patients with childhood psoriasis were evaluated at the dermatology out-patient clinic in the college of medicine at King Saud University during the period from April 2002 to June 2007. All patients were diagnosed based on clinical findings. Of the 36 patients, 24 (66.67%) had generalized plaque type psoriasis, 8 (22.2%) had guttate psoriasis, 4 (11.1%) had mixed plaque type and guttate psoriasis, 6 (16.67%) had localized plaque type (on elbows and knees), 4 (11.11%) had palmoplanter psoriasis and 1 (2.77%) had scalp psoriasis. Among those, one patient had congenital psoriasis. The age of patients ranged from 8 months to 18 years (mean = 11.3 years). There were 15 males and 21 females. The mean duration of the disease was 3.04 years and family history was positive in 10 patients (27.78%). All patients were treated by topical medications and/or narrow-band ultraviolet-B phototherapy. Apart from prolonged tanning no significant adverse effects were reported. Of particular interest, skin cancer was not detected in this series of children even after repeated courses. In conclusion, childhood psoriasis is more common in girls with plaque type psoriasis being the most common type. Topical therapy is the mainstay treatment for localized disease and narrow-band ultraviolet-B phototherapy is considered safe and effective for moderately severe conditions. More studies are required to define the safety of systemic therapy and biologic treatment in this age group of psoriasis.