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Kids can get psoriasis too

By Nancy A. Melville HealthScout Reporter.

SUNDAY, Jan. 14 (HealthScout) -- Your child comes down with a cold and soon after breaks out in small spots -- chicken pox, right? Not necessarily. For an estimated 20,000 children who are diagnosed annually, the spots are actually lesions from psoriasis.

The outbreak can come as a surprise to parents who may not realize that upper respiratory infections can trigger psoriasis, a non-contagious condition characterized by small lesions that can appear anywhere on the body, including the nails and the scalp.

In addition to being unsightly, the lesions can be itchy and painful, says Dr. Alice Gottlieb, director of the Clinical Research Centre and a professor of medicine at UMDNJ-Robert Wood Johnson Medical School in New Jersey.

"It can be disabling physically," she explains. "For example, if it's on your hands and feet, it can hurt to walk and use your hands. Psychologically, it can also be very disabling because it's very unsightly and is an embarrassing condition to have."

The condition is chronic and because there is no cure, it lasts into adulthood, says Jessica Wise, a spokesperson for the National psoriasis Foundation.

"psoriasis is known to go into remission, however some people never go into remission. What experts commonly say is that each individual has his or her own cycle, with periods of it being good and then times of it being bad," she says.

The type of psoriasis that most commonly occurs in children and teens, called Guttate, frequently follows an upper respiratory infection, although the infection does not directly cause psoriasis. Lesions from Guttate typically appear on the trunk, limbs and scalp.

Other factors that can trigger outbreaks include stress, skin injuries and strep infections.

Exact causes of the disease are unknown, but it is generally accepted that a genetic component is involved, according to the foundation. If one parent has psoriasis, the chance of a child having it is about 10 percent, and if both parents have psoriasis, the chance increases to 50 percent. One in three people reports a family history of psoriasis, but there is no pattern to the inheritance and children with no family history of the disease can develop the condition.

About one out of 40 people have psoriasis, usually starting in young adulthood. Out of those, about 10 percent to 15 percent get psoriasis before the age of 10.

Outbreaks of psoriasis are usually treated with topical steroid creams. But Gottlieb says that because the condition is much more common in adults, few psoriasis treatments have approval from the U.S. Food and Drug Administration (FDA) for children.

"Almost none of the treatments are approved for paediatric use, and most have not been tested in children," she says. "Children are usually just treated with adult drugs even though they haven't been studied on children, but the FDA is now requiring companies with new drugs to test with children."

Children with severe, life-threatening or disabling psoriasis may be treated with ultraviolet light therapy or systemic treatments such as methotrexate, Acitretin and cyclosporine.

Specifically, psoriasis involves the maturation of skin cells in just three to four days instead of the normal 28 days. Because of the excessive reproduction, skin cells build up and form the red, raised, scaly lesions.


Helping your child cope with psoriasis

Like adults affected by psoriasis, children who have the skin condition often have a difficult time coping with the realities of the diagnosis.

Children - especially young children - rely on their parents to find solace in not only their symptoms, but also the emotional challenges of having skin that looks different than other children s skin.

More than Physical Wounds

While some children show little in the way of an emotional reaction to psoriasis, others feel embarrassed, angry or sad. Children often become anxious about recurring episodes, worsening of the psoriasis and being rejected by other children their age.

It s difficult to predict how or when children will react to having psoriasis. Their moods and reactions often swing with the manifestations of the disease. Remember that having psoriasis at a young age impacts the patient s body image more severely than in adults.

You Can Help Your Child Cope

One of the best things parents of children with psoriasis can do is become educated about the disease, so they can educate their children. While a young child might be satisfied with a parent as a constant information and comfort source, older children and teens might also turn to friends or counsellors who know about psoriasis for support. Regardless of the person doing the educating and comforting, a support network is important for the child to successfully cope with the disease.

The way you educate your child should be based on the child s age and level of understanding. Sending the same message in different ways over and over again might be necessary to get them to comprehend their situation. Always be truthful but hopeful.

Encouraging points to get across include:

Psoriasis is not life threatening.

You are not alone. Millions of people have psoriasis.

Psoriasis is not contagious. Your friends don t have to be afraid of catching it from you.

There are excellent treatments available through a dermatologist.

Your openness and willingness to educate, support and address questions head on will, in most cases, make your child stronger and more willing to do the same for himself and others with the disease.

Start from the basics. It is key to educate your child about the normal process of cell production and how that goes awry with psoriasis. One way to describe psoriasis to younger children is to say: Psoriasis is a condition that makes your skin behave and look differently than normal skin. Normal skin cells take four weeks to go from the bottom skin layer to the top skin layer, where they die. In skin with psoriasis, it happens in only three to four days, so there is not time for the old cells to wear away, and the outer skin layer piles up into thick plaques that become silvery white scales. Because the exact cause of psoriasis is not known, there is no cure, but there are many treatments that can make it go away for while or at least make it feel and look better.

Some other things to communicate include:

Abating myths, such as those making the child feel like the psoriasis is her fault because she doesn't eat right, keep clean or has an abnormal personality. Assure your child that they did not bring on psoriasis. It s not their fault.

Preparing your child for the chronic nature of the disease and that it goes through cycles.

Helping your child to understand that while this is a genetic disorder, we don t know why some people have it and some don t.

Enforcing the importance of the medications and lifestyle modifications (if any) prescribed by the child s dermatologist. Tell your child how important it is that they use the medicines properly or to control the psoriasis.

Encouraging questions and inquisitiveness. Some children are better off writing down their questions. Teens might be interested in camouflaging techniques and other things that help them to feel more in control of their condition. Ensure that they get the answers to their questions from their dermatologist. Discuss their condition, both physically and emotionally, with the dermatologist.

Encouraging your child to reach out for support whenever needed and making sure the support is there.

Teaching your child patience, with the understanding that some treatments work better than others for them.

Making sure the child understands that while psoriasis might be part of who they are, it s not all of who they are.

Don t Forget to Recognize the Child s Feelings
It s one thing to communicate the medical side of psoriasis, but it s just as necessary to talk about the intangibles the feelings that the child experiences.

Tell your child that his feelings are validated by saying, It s OK to be angry, sad or frustrated, and it s OK to share those feelings with others.

Teenagers are particularly vulnerable to feeling betrayed by their skin and isolated from their peers. Remind the teen to educate others so that they are more accepting and understanding.

Empowering your child with information and support will help them through the difficult times of the disease. One place that will help is the National Psoriasis Foundation, which offers youth programs tailored to three age groups: kids (ages 5 to 8, youth (ages 9 to 12) and teens. There are games and puzzles for young children, as well as stories, that might help them to grasp your messages as a parent. The youth and teen sections offer several subsections, including opportunities for online chats, where kids can meet others with the disease, and participate in question and answer sections.

Source: National Psoriasis Foundation.

Psoriasis is much less common in childhood than other skin problems such as eczema although around 10% of adults with psoriasis seem to have developed it before the age of 10. Guttate and scalp psoriasis are more common in childhood.


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Psoriasis is a common skin disease that causes raised red skin with thick silvery scales.


Vitiligo is a disorder in which white patches of skin appear on the body

hair loss

Hair loss usually develops gradually and may be patchy or diffuse


Acne is a disorder of the hair follicles and sebaceous oil glands that leads to skin infections


Inflammation of the skin, often a rash, swelling, pain, itching, cracking. Can be caused by an irritant or allergen

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