Psoriasis is chronic autoinflammatory skin disease that speeds up the growth cycle of skin cells, which causes raised, red, scaly patches to appear on the skin, according to the Centers for Disease Control and Prevention. Treatments range from topical ointments to ultraviolet light therapy to drugs. Psoriasis is associated with other serious conditions, such as diabetes, heart disease, and depression. One-third of psoriasis cases begin in the pediatric years, and onset is most common during adolescence for the chronic, multisystem, inflammatory skin disease that causes the skin to develop new skin cells too rapidly.
That’s why the American Academy of Dermatology (AAD) and the National Psoriasis Foundation (NPF) has released guidelines to help ensure that pediatric psoriasis patients receive the best possible treatment and care. While there is no cure for psoriasis, getting treatment from a board-certified dermatologist and making lifestyle changes can help control the condition. Other recommendations include identifying and avoiding patients’ triggers, sticking to a good psoriasis skin care routine, living a healthy lifestyle, and using appropriate medications as needed.
The joint AAD/NPF Guidelines of Care for the Management and Treatment of Psoriasis in Pediatric Patients, was published in the Journal of the American Academy of Dermatology and outlines best practices for treatment of the disease. Developed by board-certified dermatologists, the guidelines are based on the most up-to-date scientific evidence for managing the disease. Because psoriasis can increase a person’s risk of developing certain diseases, like diabetes, the new guidelines address some of those conditions in young people. The link between obesity and psoriasis is greater for children than adults.
There may be a link between type 1 diabetes and psoriasis, as insulin resistance in children with psoriasis is estimated to be approximately twice that of children without the condition. Inflammatory bowel disease is three to four times more common in pediatric psoriasis patients than in kids who don’t have psoriasis. Unlike adult psoriasis patients there’s not enough evidence to support a relationship between psoriasis and heart disease in young patients, though experts recommend that children with psoriasis undergo appropriate cardiovascular screening.
Psoriasis can be exacerbated by multiple factors, including infections, stressors and skin trauma. That emotional stress can also manifest psychosocially in children with visible skin disease. Kids with psoriasis are susceptible to bullying, name-calling and shaming at school and in other social settings. Also outlined in the guidelines are the physical symptoms of the disease, which can include pain and itchiness along with stinging, burning and tightening sensations. “The physical and emotional impact of psoriasis is tremendous, especially for children,” says Randy Beranek, president and CEO of the National Psoriasis Foundation. “Treating pediatric patients with guidelines based on the most recent scientific information gives health care providers the best chance at finding the most successful course of treatment that enables children to live a healthy life.”
“Compared to adults, pediatric psoriasis patients have a unique physiology, drug tolerance and patient/caregiver/physician interaction dynamic that can make it more challenging to manage,” added board-certified dermatologist Alan Menter, MD, FAAD, co-chair of the AAD’s Psoriasis Guideline Workgroup. “Our goal with the guidelines was to compile the latest research and provide recommendations to help secure the best course of care for this young population, which has to deal with not only skin issues, but also the psychological aspects so common in the pediatric group. We’ve found that pediatric psoriasis patients have higher rates of depression and anxiety than their peers and use psychiatric medications more frequently. Those are all addressed in these guidelines in the hopes that more people will recognize the seriousness of this disease in young people.”
Alternative Medicine For Psoriasis Patients
Survey results published by dermatologists from the George Washington University in the Journal of the American Academy of Dermatology reveal that patients with psoriasis frequently use complementary or alternative therapies to treat their symptoms. Through a survey distributed by the National Psoriasis Foundation, they found that patients with psoriasis typically turned to complementary or alternative medicine when their traditional medications failed or presented harsh side effects. “Patients turn to these treatments because what was initially prescribed is not working out for them,” says Adam Friedman, MD, interim chair of the Department of Dermatology at the GW School of Medicine and Health Sciences. “But what we found through the survey is that patients may not completely understand what products will work best for them.”
Patients reported using complementary and alternative medicines that have not previously exhibited efficacy or have not been studied for the treatment of psoriasis. Vitamins D and B12 were frequently reported, though neither of which have documented efficacy against the disease. In contrast, indigo naturalis, which is a plant extract widely used in traditional Chinese medicine and recognized as a therapy for several inflammatory conditions, has shown efficacy, but was not reported in the survey. Dead Sea treatments were commonly reported and have shown therapeutic benefit. “In addition to the chosen treatments, we also found that less than half of the respondents would recommend complementary or alternative therapies to others,” Friedman added. “This could be a result of using therapies supported by limited evidence.”
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With over 30 years of writing and editing experience for newspapers, magazines and corporate communications, Kevin Kerfoot writes about natural health, nutrition, skincare and oral hygiene for Trusted Health Products’ natural health blog and newsletters.
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