Psoriasis in Children May Be Triggered by Respiratory Infections

October 06, 2000

New York (MedscapeWire) Oct 6 — Although children often contract illnesses such as colds, strep throat, and tonsillitis, it is not well known that these infections are known to trigger psoriasis in some children. In fact, about 20,000 children are diagnosed with psoriasis annually, and many of the cases are attributed to upper respiratory infections.

There are several forms of psoriasis; guttate is the one that most commonly occurs in children and teens. It is sometimes preceded by an upper respiratory infection. Guttate psoriasis is noncontagious and characterized by small drop-like lesions, usually scattered over the trunk, limbs, and scalp.

Although these common respiratory infections may trigger psoriasis, they are not the cause. The exact cause of psoriasis is unknown, but research has found that heredity plays a role. For example, if one parent has psoriasis, the chance of a child having it is about 10%. If both parents have psoriasis, the chance increases to 50%. One in three people report a family history of psoriasis, but there is no pattern to the inheritance. Children with no apparent family history of the disease can develop psoriasis.

Treatment of psoriasis in children is similar to that in adults, but many treatments are not appropriate for children due to the possibility of adverse effects from long-term treatment. Topical medications that pose the least risk of long-term adverse effects are routinely the first therapy prescribed.

Topical steroids are the most common treatment choice for children, because they are available in a range of potencies. A child's skin is very sensitive, so milder topical medications are ordinarily preferred. However, children with severe, life-threatening, or disabling psoriasis may be treated with ultraviolet light therapy or systemic treatments such as methotrexate, acitretin, and cyclosporine.

Psoriasis is a noncontagious, immune-mediated disease that affects any part of the body, including the nails and scalp. In psoriasis, the skin cells mature in 3 to 4 days rather than the normal 28 days. This excessive reproduction causes skin cells to build up and form red, raised, scaly lesions. One in 40 people has psoriasis, and about 10% to 15% get psoriasis before the age of 10.

Throughout October, the National Psoriasis Foundation (NPF) is sponsoring its fourth annual campaign to increase national awareness of the disease. This year's Psoriasis Awareness Month focuses on the needs of youth. This special youth initiative aims to help the more than 1 million children and teens who have psoriasis. More information about the disease can be found on the NPF Web site at http://www.psoriasis.org.

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