Pediatric Psoriasis Comorbidities

Nicole W. Kittler, MD; Kelly M. Cordoro, MD

Disclosures

Skin Therapy Letter. 2020;25(5):1-6. 

In This Article

Uveitis

Uveitis is associated with psoriatic arthritis in pediatric patients, although rare cases of uveitis in patients with psoriasis but without joint disease have been reported.[10–12] It can present with acute onset eye pain, redness, miosis, photophobia, or blurred vision. Compared to the uveitis associated with ankylosing spondylitis, uveitis in patients with psoriasis is more likely bilateral and insidious in onset.[13] The incidence of uveitis among children with juvenile psoriatic arthritis ranges from 8–19%, with higher rates among children with early-onset psoriatic arthritis.[4,5] In patients with onset of psoriasis and arthritis before 6 years of age uveitis appears to be severe, vision threatening and treatment refractory.[11]

A review of systems for pediatric patients with psoriasis, and particularly those with psoriatic arthritis, should include questions about ocular symptoms; patients with concerning findings should be evaluated by a pediatric ophthalmologist. Providers should maintain a lower threshold for referring patients younger than 6 years with psoriatic arthritis for ophthalmologic evaluation, as uveitis in these patients is more common and more severe.

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