Resistant childhood psoriasis: an analysis of patients seen in a day-care center.

During a three-and-one-half-year period, 54 children aged 1 to 16 years, all of whom had resistant psoriasis, were seen at a day-care center. The female: male ratio was 3:2. In 74% of the patients, the onset of psoriasis occurred when they were below 10 years of age. Papules and plaques occurred in 78% of cases, guttate lesions in 16%, and nail involvement in 21%. A family history of psoriasis was present in 69% of cases, preceding upper respiratory tract infections occurred in 35%, and prior cradle cap and/or diaper rash in 50%. In the day-care center, Goeckerman therapy was given to 31 children. The average duration of treatment was 12 days, producing maximum clearing of over 90% in 64% of patients, with substantial improvement in the remainder. After three months, the psoriasis in 83% of these patients was over 90% clear; 43% showed maximum clearing at one year. Two patients were treated with anthralin and ultraviolet light alone, one with good results. One patient with nail psoriasis alone was not treated. The remaining 20 patients were either unable to attend for treatment at the center or had less extensive psoriasis. Home treatment was prescribed for them, with less satisfactory results.