Department of Dermatology, University Hospital Erlangen, Germany.
J Dtsch Dermatol Ges. 2011 Oct;9(10):815-23. doi: 10.1111/j.1610-0387.2011.07668.x. Epub 2011 May 18.
Psoriasis of childhood shows an annual prevalence of 0.71 % and accordingly has to be regarded as a frequent chronic inflammatory skin disorder of this age. The impact on the quality of life as well as development of the afflicted children and their parents is evident. On the other side, therapy is demanding with regard to the specific juvenile metabolism, physical development and skin penetration of topical drugs. Long-term treatment at an early age has to be critically judged regarding the chronicity of the disease. Topical corticosteroids, alternatively dithranol may be used first-line, followed by vitamin D derivatives. A combination with UV-light, preferably UV-B, has to be decided on an individual basis. Systemic treatment may be initiated in recalcitrant disease with methotrexate and cyclosporine where long-term experience is available from juvenile rheumatology and transplantation medicine. Alternatively fumaric acid esters or retinoids are available. Rehabilitation procedures will help the children and their parents to cope with the disease and its treatment. The different treatment options are presented here as a German expert consensus, as clinical studies are hardly available and only a few therapeutics are licensed for this age. In any case the therapy has to be individually planned and decided together with the patients and their parents to gain maximal safety, comfort and success.
儿童银屑病的年患病率为 0.71%，因此应被视为该年龄段常见的慢性炎症性皮肤病。受其影响的儿童及其父母的生活质量和发育受到明显影响。另一方面，由于儿童特殊的新陈代谢、身体发育和皮肤对局部药物的渗透等原因，治疗具有一定的挑战性。鉴于疾病的慢性特征，在儿童早期进行长期治疗必须进行严格的评估。局部皮质类固醇或蒽林可作为一线治疗药物，然后使用维生素 D 衍生物。是否联合使用紫外线（优选 UV-B）应根据个体情况决定。对于顽固疾病，可以考虑使用甲氨蝶呤和环孢素进行系统治疗，这两种药物在儿童风湿病学和移植医学领域已有长期的应用经验。另外，富马酸酯或类视黄醇也可作为替代药物。康复程序可以帮助儿童及其父母应对疾病及其治疗。这里提供了不同的治疗选择，作为德国专家共识，因为几乎没有临床研究，而且只有少数治疗方法被批准用于该年龄段。在任何情况下，都必须根据患者及其父母的具体情况进行个体化的治疗计划和决策，以确保最大的安全性、舒适性和成功率。
