Psoriasis in children: causes, symptoms and treatment

Psoriasis in infants is rare, but if it happens, the disease is severe. Children are more likely than adults to develop complications of this skin pathology. The course of psoriasis in children has its own characteristics, and when skin rashes appear, the pediatrician should take them into account when prescribing treatment. The disease requires an integrated approach, and with its early onset, stable remission can be achieved, and thereby improve the health of the baby.

Causes of appearance

Psoriasis in infants develops as a result of simultaneous exposure to several factors:

heredity;
low immunity;
infection;
the effect of drugs;
skin injury.

Approximately 30% increases the likelihood of developing psoriasis in a newborn if this pathology was diagnosed among the closest relatives. If the mother and father of the child suffer from psoriasis at the same time, then this probability increases by almost 80%. Nevertheless, the child does not inherit the disease itself, but only a predisposition to it, and therefore, with proper care, it is possible to avoid it.

Almost always, this skin disease in infants develops against the background of a decrease in immunity. Psoriasis can be caused by previous staphylococcal or streptococcal infections, such as pharyngitis or tonsillitis, as well as chickenpox and influenza.

Activation of the psoriatic process often manifests itself during the rehabilitation period after these diseases. The initial stages of skin lesions may appear as early as 2-3 weeks after treatment.

Impaired metabolism and endocrine dysfunctions may favor the development of this skin disease. If in adults psychotraumatic factors are considered as prerequisites for the development of psoriasis, then in relation to young children they have less influence.

What to remember

Psoriasis in children can appear at any age, most often the period of the first symptoms of the disease occurs at 6 and 14 years.
The disease has different forms, most often in children the guttate type of psoriasis develops.
Children's psoriasis is not completely cured, so its treatment is aimed at relieving the unpleasant symptoms of the disease (skin rash, psoriatic plaques, itching).
Never treat psoriasis in a child on your own with any ointments, as you will only aggravate the course of the disease. The treatment regimen should be prescribed by a doctor on an individual basis.
In psoriatic arthritis, pathological changes affect not only the skin, but also the joints. If 1 joint is inflamed, then, in the absence of timely treatment, the inflammatory process will certainly spread to other joints of the body.

Types of psoriasis in newborns

The initial signs of the disease largely depend on its form. In infants, the following types of psoriasis occur:

Diaper. In the area of contact of the diaper with the skin, erythematous lesions are formed, which are covered with scales. They contain exudate. It is characterized by the presence of a border between the affected areas and healthy skin.
Plaque. Erythematous spots are formed, less often papules and vesicles. The rash appears primarily on the buttocks, then passes to the face, hands and natural skin folds. These lesions gradually thicken, increase in size, and rise above the general level of the skin. Over time, the surface begins to peel off.
Pustular. First formed on the skin red spots, which gradually transform into blisters with exudate. They inflame and swell. The child has an increase in lymph nodes. This form is the rarest.
Teardrop. Papules up to 1 cm in diameter are formed on the skin, having a rounded shape. Separate spots merge, their surface gradually begins to peel off.
Erythrodermic. It is characterized by the appearance of multiple red spots, accompanied by itching, fever and joint pain. This form is the most severe.

Stages and first signs

Symptoms of psoriasis in infants have their own characteristics. The initial stage of the disease is often confused with dermatitis. The first rashes appear on the buttocks of the child. These are spots of pronounced red color with a clear contour. With dermatitis, the contour is blurry and the shade is more pink.

The disease in children proceeds in several stages:

Initial. On the body, without being tied to any part of it, small spots of a pink hue are formed that do not cause discomfort. After a short time, easily departing silvery scales appear on their surface.
Progressive. The size of the appeared foci increases, and at the same time new spots appear, which gradually merge with the previously formed ones. The child is disturbed by burning and itching, body temperature may rise. The duration of this stage varies from 2 weeks to several months.
Stationary. The spread of spots and the growth of new ones gradually slows down and then stops. The skin begins to actively exfoliate with scales. This stage may last indefinitely.
Regressive. It is final and is characterized by the fact that seals appear in the center on existing plaques. The inflammatory process subsides, and the scales exfoliate. The spots gradually disappear.

Psoriasis, or as it is called in another way scaly lichen, at the very beginning of its manifestation may resemble other skin diseases.
The first sign of the onset of the disease is the formation of small red or pink papules on the skin. Their surface is glossy, but after a few days the shade changes and becomes silvery or grayish. In this case, their pronounced exfoliation is manifested. The papules protrude only slightly above the surface of the skin, but tend to increase in size. Gradually, they merge and form a psoriasis plaque.

Even the slightest injury to the papules leads to their bleeding. This is due to an increase in the number of capillaries in this area. The child is worried about itching, he begins to actively comb the papules. Plaque formation completes the initial stage.

Psoriasis affects any part of the body, including the scalp. Constant skin itching and irritation of the body causes discomfort, nervousness, deterioration of sleep and appetite in the baby.

What is childhood psoriasis

Children's psoriasis in most cases is accompanied by itching. In this case, the first psoriatic rashes most often appear on those areas of the skin that were previously injured. This may be a scar after vaccination or a scar formed after a bruise. This condition is called the Koebner phenomenon.

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If psoriasis (synonym: psoriasis) appears in a person at an early age, then he stays with him for life. This type of disease is chronic. As a rule, the pathology worsens in the cold season, when the child's body begins to experience a deficiency of vitamins and a lack of sunlight.

How does psoriasis start? To find out, and to be prepared to start treatment in the event of a disease, read here.

Diagnostics

Making a diagnosis of psoriasis in a child under one year old only on the basis of an external examination and symptoms is not an easy task. It often happens that in infants the disease occurs without the triad of symptoms characteristic of psoriasis:

formation of a terminal film;
small cell hemorrhage;
peeling of scales.

What is the danger for babies is psoriasis?

Difficulties in identifying psoriasis at an early stage in infants leads to the fact that the disease progresses and can become complex.

Since psoriasis is localized on any part of the body, and most often in newborns it is natural folds, including the buttocks, this carries the risk of infection of these places.

Constant contact of the contents of the diaper with the affected areas of the skin can become a favorable environment for the activation of pathogenic microorganisms. As a result of this process, infection occurs.

Regarding the question of the contagiousness of children with psoriasis, it is necessary to know that the disease is not invasive, it is transmitted in a different way.

Therapies

Psoriasis belongs to the category of chronic diseases, but with timely and proper treatment, stable remission can be achieved. And maybe in the future it will no longer manifest itself in a child, or the frequency of relapses will decrease. The selection of effective medications determines the success of treatment by more than 80%. Psoriasis requires an integrated approach.

Therapy should be aimed not only at combating the already formed pathological foci of the skin, but also at eliminating the unpleasant symptoms caused by this disease. At the first sign of an unreasonable appearance of a rash, you should contact a dermatologist.

Medication

Regarding the treatment of psoriasis, the popular pediatrician Komarovsky says that it will not be possible to completely get rid of the disease, but it is possible to develop an effective treatment regimen for it.

Drug therapy for psoriasis consists in prescribing and taking the following groups of medications:

antihistamines;
enterosorbents;
desensitizing drugs;
vitamins.

Antihistamines help reduce itching and relieve swelling. Medicines of this action are taken for several days in the active phase of the disease. For infants, medicines are prescribed in the form of drops, for example, Fenistil, Zirtek, Suprastin.

Enterosorbents are used to reduce intoxication. Desensitizing drugs are able to suppress the allergic reaction of the body and act as an anti-allergic agent. For the treatment of children, calcium gluconate solution is most often used. Vitamins are used only as prescribed by a doctor, since there is not always a need for them in this disease.

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In advanced cases of the disease, when the standard treatment regimen does not have a therapeutic effect, they resort to immunomodulatory and hormonal drugs. Medicines of similar action are prescribed taking into account the age of the child, comorbidities and drug compatibility.

When the psoriatic process has a long course, doctors replace the prescribed drugs every 2 months. This is done to avoid the development of addiction to them. During the entire period of treatment, the child's skin is examined to assess the effectiveness of therapy.

With psoriasis in newborns, topical medications are required. These are ointments and creams that help to stop the inflammatory reaction, reduce itching and pain, prevent infection and help restore the surface of the epidermis. Their appointment is carried out in accordance with the stage of the disease:

At the initial stage, Zinocap, Zinc ointment and preparations based on grease and tar are used. Against the background of their intake, the feeling of discomfort decreases, inflammation on the skin is stopped, and the penetration of pathogenic microbes into the wound is prevented.
At a progressive stage, external agents containing vitamin D (Dyvonex or Psorkutan) are prescribed. They help to stop the progression of psoriatic changes.
At the stationary stage, ointments are prescribed that accelerate the resorption of plaques. These are oil-based products.

Hormone-containing medicines are prescribed in a short course in order to avoid toxic effects on the child's body. If the lesions are minor, then they are limited to ointments containing plant components (Dawn, Videstim, Solipsor). These drugs speed up wound healing and reduce dry skin.

Physiotherapy

Comprehensive treatment involves physiotherapy. Without them, it is impossible to achieve a positive result. In the treatment of infants, phototherapy and ultraviolet radiation are used. These procedures contribute to the restoration of the skin. They also have a drying and healing effect.

For extensive skin lesions, PUVA therapy is used. This is a combination of ultraviolet radiation and the use of photosensitizers. The duration of the procedure and their frequency is determined by the doctor depending on the stage of the disease and its form.

Folk methods

Alternative methods of treatment should be used in conjunction with drug therapy prescribed by a doctor. Before you start putting them into practice, you need to consult with a specialist.

Bathing your child daily in lightly salted water will help relieve the unpleasant skin symptoms of psoriasis. It is recommended to take baths with decoctions of medicinal herbs (chamomile, sage, flax). So, a decoction of chamomile is prepared in the following way:

Forms of pathology

Psoriasis in children can be normal or severe. In this regard, doctors divided the disease into the following types:

Teardrop.
Plaque.
Pustular.
Psoriatic erythroderma.
Psoriatic arthritis.

Consider the features of each type of psoriasis separately.

teardrop

This form of psoriasis is considered the most common, but also more gentle. Single elements of the rash affect small areas of the skin of the limbs and trunk. They are in the form of small red-pink drops. It is impossible to predict where the next psoriatic element will appear, since it is formed suddenly.

Pay attention! At the initial stage of development, the disease has symptoms similar to those of a food allergy. Therefore, some parents, when they see a red rash on the child's body, most often mistake it for an allergic reaction to any food product.

Causes of teardrop psoriasis in children:

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Infectious diseases (scarlet fever, measles, rubella).
Hereditary factor (the defective gene is inherited from one or both parents).
Disorder of the nervous system (stressful situations).
Endocrine diseases (thyroid disorder).
Long-term medication (antibiotics, hormonal drugs).

Of the above possible reasons for the development of guttate psoriasis, most often this form of pathology appears in children of preschool and primary school age against the background of streptococcal lesions of the throat (tonsillitis, pharyngitis). In adolescent children, the development of this disease can occur after they have suffered measles or rubella.

To treat psoriasis effectively, you need to choose the right ointment that will speed up the healing process.

Doctors explain this factor by the fact that as a result of infection of a child with streptococci or the measles virus, the immunity of his body is reduced. Under the influence of pathogenic agents, the metabolism in the skin slows down and the normal cycle of cell division is disrupted. The latter factor causes the appearance of flaky teardrop-shaped dots on the skin.

plaque

Plaque (vulgar) form of psoriasis can occur in children at any age. Psoriatic rashes affect the skin of the inguinal folds and armpits. The rash appears on the knees and on the skin of the outer side of the elbows, as well as on the lower back and buttocks.

Initially, psoriatic plaques are covered with silvery scales, which are keratinized skin. Scales are easily removed with nails. Under them, smooth skin of a reddish-pink color appears. But if you start to remove the keratinized fragments with effort, then the diseased skin cracks, which causes bleeding wounds to appear in the plaque area.

Important! The plaque form of the pathology is accompanied by constant itching. Therefore, parents should ensure that the child does not comb scaly areas with his nails. Otherwise, this will lead to the appearance of wounds on the sore spot and their infection with bacteria. In this case, the wounds will begin to fester.

Causes of plaque (vulgar) psoriasis in children:

Наследственность. Scientists have found that this form of the disease is transmitted by an autosomal dominant and recessive method. In the first case, the presence of at least one defective gene in the genus of the mother or father of the child is implied. In the second, the child receives the mutated gene from both parents, but they are healthy.
Metabolic disorders in the body. Often plaque and other types of psoriasis occur due to impaired cholesterol metabolism (participates in the production of hormones and vitamins).
Disorders of the nervous system. Frequent stress and psychological trauma cause skin changes (flaking, rash and itching). The pathological process begins with the fact that all the nerves of the skin (sympathetic, motor, secretory, etc.) cease to function normally.

The number of occurrence of exacerbations of plaque psoriasis depends on the cause that provoked the disease, as well as on whether treatment was started on time.

pustular

If this rare form of psoriasis occurs in a newborn child, then doctors call it neonatal. This type of pathology is characterized by the appearance of purulent pustules on the thinned red skin. In this case, a pustular rash necessarily appears on the soles of the feet and palms of the hands.

Pay attention! Pustules in psoriasis appear either as the first signs of this disease, or as a complication of the plaque (vulgar) form.
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Pustular psoriasis is:

Localized (limited). A limited pustular rash may appear in the pubic region, on the soles and palms, and may also affect individual areas on the trunk. The disease proceeds in a mild form. The elements of the rash initially have clear boundaries. But after the pustules open, erosive areas with purulent crusts form in their place.

Generalized (common). This form of the disease is rare in children. Pathology begins to develop with the appearance of a red rash on the surface of the skin, which is accompanied by a burning sensation. The patient has a fever. In just a few hours, the rash spreads to all parts of the body, affects the mucous membrane of the mouth, and turns into blisters.

The reason for the appearance of pustular psoriasis in children is a weakening of the immune system and a violation of metabolic processes in the body. In turn, the development of these two problems contributes to the long-term treatment of the child with hormonal drugs, viral and bacterial infections, as well as the child's unlimited exposure to the sun.

Psoriatic erythroderma

Erythrodermic psoriasis may be the first exacerbation of the disease. But most often it appears in those children who suffer from a chronic plaque or pustular form of pathology, from photodermatosis (when the skin is highly sensitive to ultraviolet radiation), scabies or drug hypersensitivity. The disease is rare. It occurs suddenly or develops gradually.

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Exacerbation of erythroderma is manifested by a strong reddening of the skin of the entire surface of the body. Inflamed skin looks like it's on fire. This condition is accompanied by severe itching and soreness. Dead skin peels off in large layers, bleeding wounds appear in their place.

The danger of erythrodermic psoriasis is that in the absence of timely treatment, the skin completely loses its protective functions. What contributes to the penetration of infection into the body, and can also cause pneumonia, heart failure, constant fever.

Important! The condition of a patient with psoriatic erythroderma is worsened by the fact that this form of pathology turns into arthropathic psoriasis.

Psoriatic arthritis

The disease is rare in children. Pathology most often affects the body of girls from 6 years of age and older, those who have entered puberty. In children, this form of the disease has a favorable course. It rarely takes a malignant form and is complicated by pathology. internal organs (liver, heart, lungs).

Note. In children, psoriatic arthritis lasts about 7 years (periodically worsens). Then the disease enters a phase of prolonged calm (characterized by the absence of exacerbations).

Possible causes of psoriatic arthritis in childhood:

Наследственность. In the family of the child's parents, there were cases of psoriasis, rheumatism - inflammation of the connective tissue, arthritis - inflammation and destruction of the joints.
Tendency to allergies. Psoriatic arthritis can develop under the influence of different types of allergens (drug, plant pollen, food). In response to the penetration of allergen agents into the body, the latter begins to produce antibodies. They attach to microparticles of allergens. Under certain conditions that the immune system creates, these complexes settle in the joint tissues. Which leads to their inflammation and the appearance of signs of arthritis.

Frequent symptoms of this form of the disease are papules with scales. They appear on the scalp, trunk and limbs. Gradually, the elements of the rash merge into islands of various shapes. In addition, the patient periodically has pain in the muscles and inflamed joints. In the morning, the child may feel stiffness in movement and painful tingling in the heels (with a disease of the joints of the legs).

Council. It is very important that parents begin treatment of psoriatic arthritis in their child in a timely manner. Pathology is not limited to skin rash and inflammation of one joint on the arm or leg. The disease quickly spreads to healthy joints, subjecting them to an irreversible process of deformation.

Prevention

If suspicious spots appear on the skin of a newborn, you should immediately contact a dermatologist. This is a serious disease, and treatment should be prescribed by a specialist. Active therapy at the initial stage will help prevent the development of severe forms of the disease.

Once remission is achieved, the following general preventive measures are recommended to prevent relapse:

Regular hygiene procedures. You can not rub the skin, the child should not be in the water for more than 15 minutes.
Underwear and bed linen, as well as the child's clothes, are washed only with hypoallergenic detergents. In this case, things must be carefully rinsed out.
With the diaper form of the disease in infants, it is necessary to temporarily abandon diapers. This will help speed up the healing of spots and wounds on the skin.
Correction of the diet of the child and mother, if the baby is breastfed.

What is psoriasis in children on the head

Psoriasis is a disease of a dermatological nature, it is accompanied by the appearance of white foci of inflammation on the skin (papules, tubercles, plaques) and is of a non-infectious nature. Skin lesions can be seen in a variety of places, but the most common are the elbows and the head. About 8% of children of different ages suffer from this disease, even infants. Moreover, among newborns, the disease is less common in boys than in girls.

Children's psoriasis "prefers" the cold season. The manifestations of the disease on hot days subside, and in the winter season there are more outbreaks of psoriasis in children.

There are several types of disease. They differ in symptoms and localization, but the main thing that unites them is that the disease requires the immediate help of a highly qualified doctor.

Specialists distinguish the following forms of the disease in children:

Guttate psoriasis. In children with this type of psoriasis, areas of the skin on the body, legs, arms or head are strewn with red, inflamed spots. They quickly increase, and in the future there is an increased peeling of the affected areas of the skin. The disease mainly occurs after a streptococcal infection in children 4–5 years old.
Plain or plaque. Perhaps the most common form of psoriasis in children. Accompanied by the formation of red spots on the body, head, they increase over time, become covered with plaque and peel off, leaving behind wounds.
Arthropathic. According to statistics, only 10% of children with psoriasis suffer from this form of the disease. Accompanied by edema, swelling of the lower extremities, pain in the folds, conjunctivitis may occur. This is a severe form of the disease that can lead to damage to the bone and cartilage tissue of the joints.
Flexion or inverse psoriasis. The foci of inflammation are localized exclusively in places of folds, folds of the skin, in the groin and on the genitals. Accompanied by the appearance of redness, barely rising above healthy areas of the skin.
Erythrodermic. It belongs to the most dangerous forms of the disease, because it can be fatal for a baby. Accompanied by severe peeling and unbearable itching, very painful.
Pustular childhood psoriasis. The disease is typical for children older than 7 years. Refers to severe forms of the disease and is accompanied by swelling of the affected areas of the skin. Bubbles filled with exudate (liquid) appear on the body, an increase in lymph nodes is possible.
Generalized pustular. It predominantly occurs in adults. Accompanied by instant reddening of the skin, with the further appearance of purulent formations. This form of the disease is dangerous with complications, affects the functioning of internal organs, the heart and kidneys.

Only a doctor can determine the form, the degree of the disease, he will also prescribe the appropriate treatment. Self-medication leads to complications and delays the healing process.

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Pay attention! Psoriasis is not an infectious disease, but often the cause of its development is a transferred staphylococcal infection, flu, tonsillitis and a cold.

Psoriasis in children: causes, symptoms and treatment - Popular Medicine (2023)