What are the PeDRA/NPF guidelines for screening studies in pediatric patients with psoriasis?

Updated: Mar 17, 2021
  • Author: Jacquiline Habashy, DO, MSc; Chief Editor: William D James, MD  more...
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Answer

Guidelines on screening for comorbidities in pediatric patients with psoriasis have been issued by the Pediatric Dermatology Research Alliance and National Psoriasis Foundation. [57] Features include the following:

  • Overweight or obesity - Start at age 2 years; use body mass index criteria

  • Type 2 diabetes -Starting at age 10 years or puberty onset in overweight patients with two risk factors, screen every 3 years; screen obese patients every 3 years regardless of risk factors; use fasting serum glucose value for screening

  • Dyslipidemia - Start at age 9-11 years and then again at age 17-21 years; use universal lipid screening; fasting lipid panel recommended

  • Hypertension - Starting at age 3 years, screen yearly using age, sex, and height reference charts

  • Nonalcoholic fatty liver disease (NAFLD) - Starting at age 9-11 years, use alanine aminotransferase in overweight or obese children with risk factors (eg, insulin resistance, prediabetes or diabetes, central adiposity, dyslipidemia, sleep apnea, family history of NAFLD/nonalcoholic steatohepatitis (NASH); consider screening at a younger age if patients have greater risk factors (eg, severe obesity, family history of NAFLD/NASH, hypopituitarism); with normal screening results, repeat alanine aminotransferase screening every 2-3 years based on risk factors (or sooner if they increase in number or severity)

  • Polycystic ovary syndrome - Consider screening in patients with symptoms (eg, oligomenorrhea, hirsutism)

  • Gastrointestinal disease - Considering evaluating patients with decreased growth rate, unexplained weight loss, or symptoms of inflammatory bowel disease

  • Arthritis - Screen periodically with review of systems and physical examination

  • Uveitis - Only warranted in psoriatic arthritis.

  • Mood disorders and substance abuse - Regardless of age, annually for depression and anxiety; at age 11 years, annually for substance abuse

  • Quality of life - Consider using formal instrument (eg, Children's Dermatology Life Quality Index)


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