Goenaga-Vázquez Yamila, Lauck Kyle C, Hebert Adelaide A
Department of Dermatology, UTHealth McGovern Medical School, Houston, TX, United States.
Department of Pediatrics, UTHealth McGovern Medical School, Houston, TX, United States.
Int J Womens Dermatol. 2020 Oct 10;7(3):314-318. doi: 10.1016/j.ijwd.2020.09.012. eCollection 2021 Jun.
Each year, 20,000 patients aged <10 years are diagnosed with psoriasis. Pediatric-onset psoriasis has many similarities to adult-onset disease, and previous studies suggest that the incidence might be increasing in both populations.
The challenges that arise when treating patients with psoriasis, especially those age <12 years, are summarized, as well as the limited available treatment options for treating pediatric patients with psoriasis and the evidence supporting each of them.
Recently published guidelines by the American Academy of Dermatology and the National Psoriasis Foundations, as well as guidelines published by the German Society of Dermatology, provide considerable insight in managing patients who have this condition. The latest studies on pediatric psoriasis treatment were reviewed, including recent and current clinical trials with U.S. Food and Drug Administration approved and nonapproved medications, case reports, case series, and reviews. The authors also reviewed American and European guidelines, as well as recommendations from expert panels.
Currently, only six medications are approved by the U.S. Food and Drug Administration for the treatment of pediatric psoriasis: three biologics and three topical. Many off-label topical treatments have been used in pediatric psoriasis, with variable effectiveness and safety profiles. Data from adult clinical trials, as well as case reports and series from pediatric patients, suggest that other biologic medications are effective for pediatric psoriasis.
Many questions remain unanswered, leaving clinicians facing multiple challenges when encountering pediatric patients with psoriasis. This summation will help provide an overview of current on- and off-label medications for pediatric psoriasis. Pediatric clinical trials should be implemented to obtain data that can result in expanding the therapeutic spectrum for this population, parallel to their adult counterparts.
每年有20000名10岁以下的患者被诊断为银屑病。儿童期发病的银屑病与成人期发病的疾病有许多相似之处，先前的研究表明这两种人群中的发病率可能都在上升。
总结治疗银屑病患者，尤其是12岁以下患者时出现的挑战，以及治疗儿童银屑病患者的可用治疗选择有限的情况和支持每种选择的证据。
美国皮肤病学会和国家银屑病基金会最近发布的指南，以及德国皮肤病学会发布的指南，为管理患有这种疾病的患者提供了相当多的见解。回顾了关于儿童银屑病治疗的最新研究，包括美国食品药品监督管理局批准和未批准药物的近期及当前临床试验、病例报告、病例系列和综述。作者还回顾了美国和欧洲的指南以及专家小组的建议。
目前，美国食品药品监督管理局仅批准了六种药物用于治疗儿童银屑病：三种生物制剂和三种外用药物。许多标签外的外用治疗方法已用于儿童银屑病，其有效性和安全性各不相同。成人临床试验的数据以及儿科患者的病例报告和系列表明，其他生物制剂药物对儿童银屑病有效。
许多问题仍未得到解答，这使得临床医生在遇到儿童银屑病患者时面临多重挑战。本综述将有助于概述目前用于儿童银屑病的标签内和标签外药物。应开展儿科临床试验以获取数据，从而扩大该人群的治疗范围，与成人患者的情况并行。
