Pediatric psoriasis: questions for your child's doctor

Psoriasis can be a difficult condition to manage at any age, but it can pose a few additional challenges for children, as well as their families.

A chronic condition with no cure, psoriasis causes plaques or lesions that can be itchy and painful. Psoriasis can also have a significant negative impact on a young person’s qualify of life, including their self-esteem, mental health, and social development. And if that wasn’t enough, psoriasis is associated with a number of comorbid conditions that can put a child’s health at risk.

Fortunately, there are treatments that can help control psoriasis. As with many conditions, working with a healthcare provider is the first step.

Here, we look at the important members of your child’s healthcare team, as well as several key topics that parents and kids should discuss with these healthcare providers.

Pediatric dermatologist

Treatment for pediatric psoriasis is typically overseen by a pediatric dermatologist, a healthcare provider that specializes in the treatment of skin disorders in children.

Some topics to discuss with your child’s dermatologist include:

• Severity. Psoriasis may be categorized as mild, moderate, or severe. Two main factors determine severity. One is the amount of the body covered by psoriasis. The other is the impact psoriasis has on a person’s quality of life. This method can be used to determine psoriasis severity in adults as well as children.
• Symptoms. Talk to your healthcare provider about any changes in symptoms and ask if there are symptoms you should watch for.
• Triggers. Avoiding things that can trigger a psoriasis flare or exacerbate symptoms is an important part of managing psoriasis. Ask about triggers to avoid and ways to keep track of potential triggers.
• Treatment options. Depending on the severity of the psoriasis, there are a number of therapy options your pediatric dermatologist may recommend. These include topical treatments, phototherapy, and systemic therapies. Parents should ask about the risks and benefits of specific treatments.
• Dosage. Make sure to have clear instructions on how every medication is used, including the dosage and frequency.
• Treatment side effects. Psoriasis treatments can cause side effects. Ask what side effects to watch for.

Pediatric rheumatologist

Psoriatic arthritis is a type of arthritis that affects some children who have psoriasis. Psoriatic arthritis causes inflammation in the joints. Over time it can lead to permanent damage and disability. It is caused by the same abnormal immune system activity that causes psoriasis. Treatment for psoriatic arthritis is overseen by a rheumatologist, a healthcare provider that specializes in the treatment of autoimmune and musculoskeletal disease.

Pediatrician

It's also important to keep regular appointments with your child’s pediatrician to keep up to date on vaccinations, preventive care, screenings for other health conditions, and to discuss any other health concerns. Some important topics to discuss include:

• Weight. Being obese or overweight is more common among children with psoriasis, though the relationship between the two conditions is not fully understood. Talk to your child’s pediatrician about your child’s weight and how to encourage healthy habits around food and exercise.
• Blood sugar and cholesterol. People with psoriasis are at a higher risk of several health conditions associated with high blood sugar and insulin resistance, including diabetes and polyendocrine metabolic ovarian syndrome. They are also at a higher risk of cardiovascular disease.
• Medications. Your child’s pediatrician should know about all medications your child is taking, including therapies for psoriasis as well as others.
• Bathroom habits. People with psoriasis are at a higher risk for inflammatory bowel disease. Talk to your pediatrician about bathroom habits and any gastrointestinal symptoms or abdominal pain.
• Mood and social behavior. Psoriasis can have a profound impact on a child’s self-esteem, social development, and mood. People with psoriasis of all ages are at a greater risk of depression, anxiety, substance abuse, and other mental health conditions.

Parents and healthcare providers should encourage kids of all ages to be active participants in their appointments. Psoriasis is a life-long condition that requires life-long care. Learning how to communicate with healthcare providers is a valuable skill that can benefit kids as they grow.