Bronckers I M G J, Paller A S, van Geel M J, van de Kerkhof P C M, Seyger M M B
Department of Dermatology, Radboud University Medical Center, René Descartesdreef 1, PO Box 9101, 6500 HB, Nijmegen, The Netherlands.
Department of Dermatology and Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
Paediatr Drugs. 2015 Oct;17(5):373-84. doi: 10.1007/s40272-015-0137-1.
Psoriasis is a common chronic immune-mediated inflammatory skin disorder and begins in childhood in almost one-third of the cases. Although children present with the same clinical subtypes of psoriasis seen in adults, lesions may differ in distribution and morphology, and their clinical symptoms at presentation may vary from those reported by adult patients. Nevertheless, diagnosis of psoriasis is primarily based on clinical features. Pediatric psoriasis can have a profound long-term impact on the psychological health of affected children. Additionally, pediatric psoriasis has been associated with certain comorbidities, such as obesity, hypertension, hyperlipidemia, diabetes mellitus and rheumatoid arthritis, making early diagnosis and management essential. As guidelines are lacking and most (systemic) treatments are not approved for use in children, treatment of pediatric psoriasis remains a challenge. A prospective, multicenter, international registry is needed to evaluate these treatments in a standardized manner and ultimately to develop international guidelines on pediatric psoriasis. This article reviews current concepts in pediatric psoriasis including epidemiology, clinical features, diagnosis, the role of topical and systemic agents and the association with other morbidities in childhood.
银屑病是一种常见的慢性免疫介导的炎症性皮肤病，近三分之一的病例始于儿童期。虽然儿童银屑病的临床亚型与成人相同，但皮损的分布和形态可能不同，其初发时的临床症状也可能与成年患者报告的不同。然而，银屑病的诊断主要基于临床特征。儿童银屑病会对患病儿童的心理健康产生深远的长期影响。此外，儿童银屑病还与某些合并症有关，如肥胖、高血压、高脂血症、糖尿病和类风湿性关节炎，因此早期诊断和管理至关重要。由于缺乏相关指南，且大多数（全身性）治疗方法未被批准用于儿童，儿童银屑病的治疗仍然是一项挑战。需要一个前瞻性、多中心、国际性的登记系统，以标准化方式评估这些治疗方法，并最终制定关于儿童银屑病的国际指南。本文综述了儿童银屑病的当前概念，包括流行病学、临床特征、诊断、局部和全身用药的作用以及与儿童期其他疾病的关联。
