Children and Psoriasis - Facts and Information
Psoriasis is a recurrent skin condition that affects around 2% of the population. In simple terms, it is only an acceleration of the usual replacement processes of the skin. Normally a skin cell matures in 21 to 28 days during its passage to the surface where a constant invisible shedding of dead cells, as scales, takes place. Psoriatic cells, however, are believed to turn over in two to three days and in such profusion that even live cells reach the surface and accumulate with the dead cells in visible layers.
What does it look like?
It appears as raised red patches of skin covered with silvery scales. It can occur on any part of the body although elbows, knees and the scalp are usual sites. There is often accompanying irritation.
Is it catching?
Most definitely not. Psoriasis cannot be caught from other people nor can it be transferred from one part of the body to another.
How does psoriasis affect children?
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 although many children will also have the usual distribution of plaques over the knees, elbow and lower back.
What is guttate psoriasis?
The onset of psoriasis in children is often an outbreak of what is called guttate psoriasis. Gutta is the latin word for drop and this describes the small scaly patches affecting the trunk, limbs and occasionally the scalp. There may be a few rather larger patches or they may develop in time. This type of rash often follows an infection, often one caused by streptococci in the throat. Usually the rash clears well, although it can take several weeks or months, but in some children it can linger indefinitely. If a child has a tendency to tonsillitis the rash may come back with each attack.
Do babies get psoriasis?
It is exceedingly rare for babies to have psoriasis particularly if there is no history in the family. Rashes in the nappy area may be psoriasis or may be a straightforward nappy rash. Psoriasis in the nappy area will look red and shiny and it will be very clearly demarcated i.e. it will be very obvious where the rash stops and normal skin takes over.
What causes psoriasis?
Certain genes have been identified as being linked to psoriasis. It appears, however, that a genetic tendency needs to be triggered off by such things as injury, throat infection, certain drugs and physical and emotional stress. Research is beginning to unravel the genetic aspects and in time it should be possible to identify those who have a tendency to psoriasis before they actually develop signs. If one parent has psoriasis the chances of a child developing it is around 15%. However if both parents have psoriasis the chances increase to around 75%.
What treatments are available?
Treatment must steer a course between doing too little and too much. Too little and worthwhile improvement is denied; too much and the life of the child and family is burdened by it. It is most important that parents talk through in detail the treatments proposed with the GP or Consultant. Many treatments in use for adults will help children but because of a lack of medical research on the effects on children some treatments are not licensed for use in childhood. It is important to follow instructions carefully and to keep the skin moisturised.
Immunisations
All the usual immunisation procedures may be safely given but it is worth remembering that a patch of psoriasis may come up at any site where the skin has been 'injured' .