Pediatric Psoriasis (Ped PsO) Explained

What is Ped PsO?

We are still trying to understand what causes Ped PsO, but evidence suggests that there is a genetic link. In fact, 72% of children with psoriasis have at least one immediate relative with the condition.

Once thought of and treated as a skin disease, it is now known that psoriasis is an autoimmune disease. This means that your child's immune system, which usually protects against infection, mistakenly attacks healthy tissues in your child's body. Psoriasis is a chronic (long-term) disease of the immune system that causes patches of inflamed (reddened) skin covered with silvery-white scales, which are referred to as "plaques."

Thirty three percent of people with psoriasis develop it in the first 20 years of life. Ped PsO affects boys and girls in equal numbers and affects children 17 years of age and younger.

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What are the signs and symptoms of Ped PsO?

While psoriasis in adults often appears as deep red patches with silver scales, it can present differently in children, making a diagnosis of psoriasis more difficult. In children, these patches, called lesions or plaques, are smaller, thinner and tend to be less scaly. Your child's doctor will look at the skin and what happens when a scale is removed, as well as changes to the nails to confirm a Ped PsO diagnosis.

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Where can plaques occur?

Where psoriasis shows up on the body can also differ in children compared with adults. It is more common for psoriasis to appear on the face and joints (i.e. elbows, knees) in children. The plaques can also appear on the scalp.

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How do plaques form?

When your child's immune system mistakenly attacks healthy tissues in their bodies and inflammation of their skin occurs, it causes new skin cells to be produced much more quickly than normal.

A healthy skin cell typically takes 28 to 30 days to be produced – growing from the deeper layers of your child's skin, then rising to the surface where it is then shed.
With psoriasis, the same process only takes 3 to 4 days.
That's why psoriatic skin cells might appear to "pile up," building up with other cells to form thick, scaly plaques that do not shed in the way that healthy skin cells do.

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What are "triggers," and how might they affect Ped PsO?

Over time, the skin lesions (patches of inflamed skin, also referred to as plaques) may get better for a while or worse for a while. A "trigger" is something that can cause psoriasis to "flare up" or worsen. In other words, the inflammatory condition of psoriasis is already present, but a trigger can set off a worsening of the signs and symptoms.

There are many types of triggers, and they vary from person to person. It's not always possible to identify what has triggered a flare-up; however, there are some well-known triggers.

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Triggers in children may include:

Stress: Emotional stress can worsen symptoms in children

Infection: One third to one half of all young people with psoriasis may experience a flare up 2 to 6 weeks after an earache, strep throat, bronchitis, tonsillitis or a respiratory infection

Trauma: Areas of skin that have been injured or traumatized occasionally become the sites of psoriasis, known as the "Koebner (keb ner) phenomenon"

Medications: Reactions to certain drugs may cause flare-ups. Ask your doctor for more information, especially related to other medications your child may be taking regularly or from time to time

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