What's wrong with Mia?
What is life like for Mia and her family?
Let’s meet our patient Mia and her family who are going to help us understand the impact of moderate to severe psoriasis for all the family.
Note: Mia is an expert-reviewed theoretical case for educational purposes only.
In this introductory animation, Mia’s worried parents take her to see a new paediatric dermatologist. Mia has continued to put on weight and become increasingly withdrawn at school and depressed and so she has been referred by her primary care physician.
Find out about the treatments that Mia has tried in the past in the next section of the Learning Zone
Keep reading to find out about the complexities of diagnosing and treating childhood psoriasis.
Psoriasis is common in children and they may need lifelong treatment
The prevalence of psoriasis in children is difficult to determine as many cases are either missed or misdiagnosed and it varies by age, gender, psoriasis definition, study design and geographical region3.
Figure 1. Range of childhood psoriasis prevalence (percentage of population) (adapted from Burden-Teh et al.4).
Diagnosing psoriasis and measuring QoL is more difficult in children
Diagnosis
Although the clinical subtypes of psoriasis in children are similar to adults, diagnosis in children is more challenging.
In a study of 887 patients <18 years, the most common subtypes of psoriasis were7:
- plaque psoriasis (73.7%)
- guttate psoriasis (13.7%)
- scalp psoriasis (7.6%)
- pustular psoriasis (1.1%)
Comorbidities are often present in childhood psoriasis
Children with psoriasis are at greater risk of obesity, diabetes, anxiety and depression and show marked impairment in emotional, social and school functions25–27.
Treatment data and options are more limited in childhood psoriasis
There are a plethora of treatments available for adults with moderate-to-severe-psoriasis but a lack of efficacy and safety data in paediatric populations means there are far fewer approved treatments available to children and widespread off-label use34.
References
- World Health Organization. Psoriasis. 2016. Available at: https://www.who.int/publications-detail/global-report-on-psoriasis. Accessed 27 April 2020.
- Paller AS, Singh R, Cloutier M, Gauthier-Loiselle M, Emond B, Guérin A, et al. Prevalence of psoriasis in children and adolescents in the United States: A claims-based analysis. J Drugs Dermatology. 2018;17(2):187–194.
- Bronckers IMGJ, Paller AS, van Geel MJ, van de Kerkhof PCM, Seyger MMB. Psoriasis in children and adolescents: Diagnosis, management and comorbidities. Pediatric Drugs. 2015;17(5):373–384.
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Developed by EPG Health for Medthority. This content has been developed independently of the sponsor Novartis Pharma AG, who have had no editorial input into the content. EPG Health received unrestricted educational funding from the sponsor in order to help provide its healthcare professional members with access to the highest quality medical and scientific information, education and associated relevant content.