Psoriasis in children
What is psoriasis?
Psoriasis is a chronic, non-infectious disease of the skin that manifests itself in the early years. This condition is identified by red dry patches with silvery white scales and sores with bleeding spots. These lesions can occur anywhere on the body but is mostly common in areas such as the scalp, elbows, knees and nails. Psoriasis is a hereditary disease which is not contagious and is associated with occasional joint pains and swelling.
Where does psoriasis occur?
Psoriasis occurs in the epidermis [upper layer of the skin]. This layer consists of living cells that divide and migrate in an upward direction to form a tough layer called the ‘horny layer’. The layer functions in the protection to the underlying structures. The process of the ‘horny layer’ formation occurs within 30 days but in the condition of psoriasis the process is shorten to about 4-7 days.
Due to the rapid cell regeneration, the cells that reach the surface of the skin begin to accumulate. This results in the development of scales in the skin, representing a thick ‘horny layer’. The skin under the ‘horny layer’ appears to be red, due to the increase in blood supply required to sustain the rapid cell growth.
What are the causes of psoriasis in children?
Psoriasis varies in the levels of severity from the trivial to the more life threatening cases with many causes associated with this condition:
*Trauma to the skin such as a surgical scar or scratch can cause psoriasis to develop in the area. This occurrence is known as koebner phenomenon.
*Infection caused by the streptoccal bacteria may cause psoriasis
*Drugs such as beta blockers, lithium and antimalarias can worsen psoriasis.
*Psychological factors such as stress, anxiety, tension and worry can exacerbate psoriasis.
*Alcohol may be an aggravating factor in the condition of psoriasis
Symptoms of psoriasis in children
The basic cause of psoriasis is directed towards the relief of symptoms. These symptoms include:
*The scaling of the skin due to the rapid growth rate of cell regeneration
*Thickening of the skin occurs due to the accumulation of skin cells
*The skin appears red due to the dilation of capillaries underlying the skin
What treatment can help in the management of psoriasis in children?
Psoriasis should be viewed as a chronic illness much like diabetes which can be controlled but not cured. However relief can be provided for the sufferer in the following ways:
*Salt water helps to alleviate the discomfort of psoriasis
*Exposure to sunlight has a beneficial effect as in most case psoriasis tends to improve
*Group therapy helps the psoriasis sufferer develop confidence and hope as they have the opportunity to discuss their condition with other sufferers.
*Symptoms are improved when vitamin D, zinc or linoleic acid is increased in the dietary intake
*Fish oils suppresses substance such as leukotrienes that trigger inflammation
* Topical medications such as calcipotriol, salyclic acid, dithranol and corticosteroids remove excess scales from the skin. These preparations must be used under supervision as side effects are common.
* Crude coal tar ointment is the most effective remedy as it slows down the growth rate of the epidermis [upper layer of skin cells]. This ointment must be used at night to prevent sunburn
* Oral systemic medication such as etretinate, methotrexate, hydroxyurea and cyulosporin are used for the severe cases of psoriasis. The side effects of these medication includes: dryness of the lips, liver and kidney damage and darkening of the skin
*PUVA inhibits cell regeneration preventing the thickening of the skin from forming
Psoriasis that is life threatening or unresponsive to topical treatment may require systemic treatment. Benefits must be weighed against the side-effects of these therapies. The use of toxic drugs is used by the justification of their ability to transform a childs life from severely restricted to leading an almost normal life.