Medical Treatment Topical Agents
The first line of treatment for psoriasis includes topical medications applied to your skin. The main topical treatments are corticosteroids , vitamin D-3 derivatives, coal tar, anthralin, and retinoids. These drugs may lose potency over time, so often they are rotated or combined. Ask your doctor before combining medications, as some drugs should not be combined.
What Is Secondary Care
Secondary care is usually when your GP refers you to a hospital, or specialist centre to be seen by a consultant dermatologist, who is a doctor trained and specialising in skin conditions, and will be better placed to give advice on treatments that your child requires. More potent medications/treatments are only available at secondary care level. Your child will have a thorough assessment of their condition and confirmation of existing diagnosis made or further tests advised if thought needed. In many cases you will be referred back to your GP with a treatment plan.
Less Common Types Of Psoriasis In Children
Kids aren’t likely to get these types of psoriasis:
- Pustular psoriasis. This shows up as blisters on red or swollen skin on the hands and feet. If a child does get it, it’s typically either milder than an adult would have or a kind called annular pustular psoriasis that causes a red ring around the blisters.
- Inverse psoriasis. This happens in the folds of the body: under the knee, in the armpit, or around the groin. It looks very red, smooth, and shiny.
- Erythrodermic psoriasis. This is a severe form that can be life-threatening. It causes redness over most of the body. It’s very itchy and painful and can make skin come off in sheets.
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What Causes Genital Psoriasis
Genital or anogenital psoriasis may be part of more generalised psoriasis. Psoriasis has multifactorialgenetic and environmental causes. These are not fully understood. In the anogenital area, specific factors to consider include:
- Colonisation by bacteria and yeasts
- Injury to the skin, causing new plaques of psoriasis to develop
Psoriasis in the genital area may also be worsened by contact with irritants such as:
- Friction associated with sexual intercourse.
How Taltz Can Help Kids And Teens
Taltz is for adults and children 6 years and older with moderate to severe plaque psoriasis who may benefit from taking injections or pills or treatment using ultraviolet or UV light .
Select Safety Information
Taltz affects the immune system. It may increase your risk of infections, which can be serious. Do not use Taltz if you have any symptoms of infection, unless your doctor tells you to. If you have a symptom after starting Taltz, call your doctor right away.
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What Does Psoriasis Look Like On Black Skin
Around 125 million people worldwide have psoriasis. A 2014 study involving more than 6,000 people found that the prevalence of psoriasis was about 1.9 percent in Black participants and 3.6 percent in white participants. But psoriasis rates among Black folks may be even higher IRL.
Psoriasis can be easy to spot on white skin. It shows up as pink or red lesions with silvery scales. But on Black skin, lesions tend to be purple or violet with gray scales. This might make the condition harder to diagnose.
PSA: According to the National Psoriasis Foundation, people with darker skin receive incorrect diagnoses or go undiagnosed with psoriasis more often than light-skinned people.
Anyone can have psoriasis. It isnt exclusive to one ethnic group or age group. But symptoms can vary based on your skin type and tone.
Heres how the most common forms of psoriasis appear on Black skin.
Complications Of Juvenile Arthritis And Its Prevalence
Juvenile psoriatic arthritis is the most common comorbidity of psoriasis. Because of difficulties in diagnosis and classification of psoriatic arthritis in children, prevalence data range from 1% to 10% of children with psoriasis. The peak of onset in childhood is between ages 9 and 12, and skin psoriasis often precedes psoriatic arthritis. A relationship between nail involvement and psoriatic arthritis in adults has been suggested, and a recent study in children supports this correlation.
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Can Psoriasis Affect Only My Nails
In some cases, psoriasis may involve only the fingernails and toenails, although more commonly, nail symptoms will accompany psoriasis and arthritis symptoms. The appearance of the nails may be altered, and affected nails may have small pinpoint pits or large yellow-colored separations on the nail plate called “oil spots.” Nail psoriasis can be hard to treat but may respond to medications taken for psoriasis or psoriatic arthritis. Treatments include topical steroids applied to the cuticle, steroid injections at the cuticle, or oral medications.
How To Be Intimate When You Have Genital Psoriasis
If you have genital psoriasis, you can still be intimate. Following this advice can help reduce irritation:
When the skin on or around your genitals is raw, postpone sex.
Before sex, gently cleanse the area. Be sure to use a mild, fragrance-free cleanser. Cleansing will also help prevent psoriasis medication from rubbing onto your partner.
Men: Use a lubricated condom. Whether a man or woman has genital psoriasis, this lessens the risk of irritating the inflamed area.
After sex, gently wash the area. This helps reduce irritation. If you are using medicine, apply it.
Psoriasis is not contagious
If you have sex with someone who has psoriasis, you will not get psoriasis. Psoriasis is not contagious. Its not a sexually transmitted disease.
ReferencesBergstrom, KG, Kimball AB. 100 questions & answers about psoriasis. Sudbury, Mass: Jones and Bartlett.
Meeuwis KA, de Hullu JA, et al. Genital psoriasis awareness program: Physical and psychological care for patients with genital psoriasis. Acta Derm Venereol. 2015 Feb 95:211-6.
Ryan C, Sadlier M, et al. Genital psoriasis is associated with significant impairment in quality of life and sexual functioning. J Am Acad Dermatol. 2015 Jun 72:978-83.
Turner J. Inverse psoriasis. National Psoriasis Foundation webinar, presented September 16, 2015.
All content solely developed by the American Academy of Dermatology
The American Academy of Dermatology gratefully acknowledges the support from Amgen and .
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What Questions Should I Ask My Doctor Or Healthcare Provider
Always get your concerns answered about any treatments that your child is about to be given. Ask about any side-effects both short and long-term. If you feel that you will not be able to comply with a treatment regime because it is too complicated, time consuming or feel it is unacceptable for your child, as it may be too distressing for them tell your doctor or healthcare provider.
A programme that suits you and your child is essential to ensure good compliance and results. Remember you know your child and you know what is achievable at home, lifestyle also plays a vital part in compliance with medication. If it is too sticky or has to be applied very early on a cold winters morning it is not going to do anyone any good, but cause more stress for all, so a good treatment plan is important. Ask your doctor or healthcare provider for alternative formulations which are cosmetically more acceptable, or maybe see if you can use treatments once a day.
How To Get A Diagnosis For Psoriasis On Black Skin
The only way to know for sure that you have psoriasis is to go to a dermatologist.
Theyll perform a physical exam, looking for signature signs of psoriasis like lesions, scaling, or flaking skin.
Your doc may also do a skin biopsy, removing a small amount of your skin to test it for psoriasis. This is a good option if a physical exam isnt 100 percent accurate.
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Who Should I See About My Childs Psoriasis
Once you have noticed that something is wrong with your child and has not cleared up within a short period of time you should make an appointment with your doctor to discuss this. The doctor will then make a diagnosis and discuss a treatment plan with you and explain what your child has. If the doctor feels it necessary, he may suggest referring your child on to secondary care to see a specialist in skin problems, this will be a dermatologist. However, if this is not the case, your GP may feel happy that your childs problem can be controlled and managed in their care, prescribing topical creams to help clear the condition up.
Should you after a reasonable length of time feel you would like to consult a specialist about your childs problem as it does not seem to be responding to treatment, then you can request a referral to secondary care.
Measles: A Facial Rash That Can Cover The Body
Like guttate psoriasis, measles also follow symptoms of an upper respiratory infection in children and cause a skin rash of small, red spots. However, the measles skin rash usually starts on the face and spreads down to cover the body and is accompanied by fever, cough, and a runny nose. Measles rash is also flat, while the rash of psoriasis is typically raised. Measles is caused by a virus and is contagious, though the measles vaccination has made this a rare disease in the United States.
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Plaque Psoriasis: Red Bumps And Silvery Scales
Plaque psoriasis is the most common form of the chronic skin condition, affecting about 80 percent of people with psoriasis. Usually starting as small red bumps on the skin, plaque psoriasis develops into red patches with a silvery, scaly coating these raised patches are called plaques. Plaques usually show up on elbows, knees, and the lower back, and they can last for months or even years without treatment.
What Is The Outlook For Children With Psoriasis
Psoriasis in children may completely clear up within months of presentation, especially if guttate plaques occur in response to an infection. However, some children progress to have long-term psoriasis, often life-long. Early-onset large chronic plaque psoriasis tends to be particularly persistent and challenging to treat. Complications such as psoriatic arthritis and non-alcoholic fatty liver disease may occur.
Children with severe psoriasis should be advised to maintain a healthy weight, take regular exercise, and to avoid smoking.
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Home Treatment For Psoriasis
There are some home remedies that may help minimize outbreaks or reduce symptoms of psoriasis:
- Exposure to sunlight.
- Apply moisturizers after bathing to keep skin soft.
- Avoid irritating cosmetics or soaps.
- Do not scratch to the point you cause bleeding or excessive irritation.
- Over-the-counter cortisone creams can reduce itching of mild psoriasis.
A dermatologist may prescribe an ultraviolet B unit and instruct the patient on home use.
Incidence Of Psoriasis In Children
Psoriasis is quite common in children. According to the National Psoriasis Foundation , each year an estimated 20,000 children under age 10 years are diagnosed in the United States.
Most people experience their first psoriasis episode between ages 15 and 35 years old, but it can develop in children much younger and in adults much older. According to the NPF, around one-third of adults with psoriasis say their symptoms began when they were under 20 years old.
For some children, psoriasis symptoms may become less severe and less frequent as they grow older. Others may continue to deal with the condition throughout their lives.
Healthcare professionals can typically tell whether a person has psoriasis by looking at their skin. During a physical examination, a healthcare professional might ask:
- which symptoms your child is experiencing
- whether theyre having joint pain, which could indicate juvenile psoriatic arthritis
- which medications your child is taking
- whether theres a family history of psoriasis
- whether your child has been exposed to any of the common triggers of psoriasis
Diagnostic tests are not usually necessary, but in some cases, a biopsy may be performed. A healthcare professional can use the biopsy results to help them distinguish between psoriasis and similar-looking conditions, such as eczema.
Currently, theres no cure for psoriasis. Treatment focuses on easing symptoms when they occur and helping prevent or reduce the severity of flare-ups.
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Will Psoriasis Affect My Childs Education
There is no reason why your childs education should be affected, but a visit to the school with your child to make sure their teacher knows the essential facts about psoriasis might help. Take leaflets and fact sheets with you to leave behind. Make sure your child feels comfortable talking about psoriasis with you and the school, so they will bring any problems to your attention. Ask the school how they will tackle any bullying issues if your childs psoriasis is quite noticeable and devise avoidance tactics to pre-empt any possible situations occurring.
The school should realise that there will be periods when your child may not want to participate in P.E sessions during flare-ups and this should be explained to the school so that they can avoid any stressful situations for your child.
Swimming can be a particularly difficult for a child with psoriasis, as the chlorine in the water can make psoriasis patches worse than they actually are and more pronounced, so your child may become upset over this or embarrassed..
As your child gets older consider encouraging him or her with the following advice:
Why Does My Child Have Psoriasis
The heredity factor seems to play a part. About one third of people with psoriasis are able to identify a relative, living or dead, with psoriasis. It is estimated that if 1 parent has psoriasis that there is a 15% chance that a child will develop the condition. If both parents have psoriasis this increases to about 75%. Interestingly, if a child develops psoriasis and neither parent is affected there is a 20% chance that a brother or sister will also get psoriasis. This is because the condition is known to skip generations but somewhere there will be a familial link to a relative via either or both parents.
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Treatments Your Physician May Prescribe
Unfortunately, there is no cure for psoriasis, but multiple treatments are very helpful at controlling it.For disease that affects only the skin , topical treatments may be prescribed:
- Mid-to-high-potency topical steroids for the body or scalp and low-strength topical steroids for the face and skin fold areas as needed. Stretch marks and thinning of the skin can result from overuse of topical steroids, particularly in skin fold areas.
- Vitamin D creams may be prescribed and are sometimes combined with topical steroids.
- Vitamin A-based creams may be prescribed, sometimes in combination with topical steroids.
- Calcineurin inhibitors may be prescribed.
- Tar-based therapies are sometimes used. These therapies may have a foul odor and cause irritation in some people.
- Anthralin creams may be prescribed, but these may stain skin and cause irritation.
- For the scalp, oils, gels, foams, or solutions, some of which include topical steroids, are used in combination with tar or salicylic acid shampoos.
For more extensive disease:
Can Psoriasis Cause Pain
If you child has psoriasis on parts of their body, especially their feet or hands, bear this in mind, as sometimes it may hurt them. This could be because they have scratched the lesions and made them sore, the medication has caused some irritation, even down to the weather temperatures. Cold weather can make the skin really sore and so anything against the skin may irritate and cause pain. Perhaps slightly bigger shoes for periods when their feet hurt may allow some comfort. In the summer the heat may make their feet sweat, this again can cause some discomfort, so perhaps keeping them as dry as possible with some talcum powder may prove useful.
With their hands, the temperature and weather can play havoc too. Cold weather, dry, sore, even cracked skin, causing tightness will bring discomfort so be aware of this and try to encourage them to wear gloves and keep their hands well moisturised to help prevent cracking and soreness. In the summer, moisturising their hands keeps them in good condition avoiding the drying out and cracking of skin. Never a good idea to scratch patches, as this leads to possible infection, bleeding and pain, so if you can, discourage them from scratching.
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Types Of Psoriasis In Children
There are five types of psoriasis, but some are much more common in children than others. The symptoms can show up differently in children, too. For example, they’re more likely to have psoriasis on their face or around joints.
The two types children are most likely to get are:
- Plaque psoriasis. Most kids who have psoriasis have this type. It causes red, dry patches called plaques. It can also cause silvery scales. The plaques or scales usually show up on knees, elbows, lower back, and the scalp. They’re itchy, red, and sometimes painful. They can also bleed. Plaque psoriasis patches are smaller, thinner, and less scaly in children than in adults.
- Guttate psoriasis. This kind is also called “drop-like” psoriasis. It causes small red dots to form on the trunk, back, arms, and legs. It’s most likely to be triggered by a strep infection. Many children who get this type of psoriasis also develop plaque psoriasis.
Children under 2 can get psoriatic diaper rash. It happens on the skin that’s covered up by the diaper. It may show up like plaque psoriasis, or it may cause a bright red, weeping rash. You can tell the difference between psoriatic diaper rash and regular diaper rash because psoriatic diaper rash doesn’t get better with regular diaper rash treatment.