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Psoriasis is a disease characterised by chronic inflammation of the skin and the accelerated renewal of the epidermis. This results in the appearance of red plaques covered in silvery-white scales.
It is not uncommon for babies and children to suffer from psoriasis – this is referred to as Pediatric Psoriasis. This is a lifelong condition with no cure, but is usually mild to moderate and there are a range of effective treatments available to ease the discomfort and help the skin – and baby.
Psoriasis isn’t contagious but it can run in families depending on genetics. Typically, a bacterial infection such as strep throat or impetigo triggers psoriasis in a child for the first time and other times, children can inherit it.
Psoriasis follows a chronic course, with flare-ups interspersed with periods of remission during which symptoms diminish or disappear altogether.
Most of the time it is a benign condition, but one that can have a major impact on daily life and a significant psychological impact.
SOME FACTORS THAT INCREASE A CHILD’S RISK OF GETTING THE DISEASE:Back to top
- Being obese
- Certain medications, like lithium, beta-blockers, or malaria drugs
- Cold weather
- Cuts, scratches, sunburn, or rashes on the skin
- High levels of stress
TYPES OF PSORIASIS IN BABIES AND CHILDRENBack to top
Five types of psoriasis exist, but some of these types are more common for children to experience. The symptoms may also differ from child to child, where some will have worse conditions around the face whilst others will have worse conditions around their joints.
The two types children mostly get are Plaque – and Glutate psoriasis.
Plaque psoriasis is the most common in children and causes dry, red skin patches covered with silvery scales. These patches tend to show up on the knees, elbows, lower back, or scalp. Plaques can be itchy and painful, and they sometimes bleed. Children who have this type usually get smaller, thinner patches of skin which is usually less scalier than adults with this type of psoriasis.
Glutate psoriasis causes tiny red spots on the trunk, arms and legs. It’s most likely caused by a streptococcal throat infection. Children who get this often go on to develop other types of the disease.
Psoriatic nappy rash can happen in babies, usually under 2 years old. This happens on skin that’s covered up by the nappy.
Psoriatic nappy rash and normal nappy rash look different from one another.
Normal nappy rash gets better with cream, where psoriatic nappy rash doesn’t improve with ordinary creams. If you think your baby may have psoriatic nappy rash, wash your baby’s bottom with a clean washcloth twice a day to dry it, and apply a medicated ointment or cream. Your baby may need prescription cream – so if your baby’s nappy rash is not getting better, talk to your doctor or paediatrician to prescribe a medicated cream and treatment plan.
ADULT PSORIASISBack to top
Signs and Symptoms
Common signs and symptoms of psoriasis include:
- A skin condition that is characterized by small, scaly, itchy, pink or reddish patches on the skin – this can range from dandruff-like scaling to major eruptions all over the body
- Rashes that vary in colour, tending to be shades of purple with gray scale on brown or black skin and pink or red with silver scale on white skin
- Small scaling spots – often seen in children
- Cracked and dry skin which may bleed on occasion
- Burning, soreness and itching
- Rashes which arise in cycles which flare up for a few weeks and then subside
There are several types of psoriasis, of which each varies in size and symptoms:
The most common form of psoriasis, plaque psoriasis, causes dry, itchy, raised skin patches (plaques) covered with scales. These patches can vary in color, depending on ethnicit. The affected skin can heal with temporary changes in color (post inflammatory hyperpigmentation), particularly on brown or black skin.
This type of psoriasis affects the fingernails and/or the toenails, which causes pitting, abnormal nail growth and discoloration. Known as Onycholoysis, the nail may loosen and separate from the nail bed, and in severe cases cause the nail to completely crumble.
A chronic variant of psoriasis that characteristically affects the skin of the palms and soles and produces significant functional disability. It features hyperkeratotic, pustular, or mixed morphologies.
Affecting mostly children and young adults, Guttate psoriasis is usually triggered by a bacterial infection like strep throat. These appear by small, teardrop-shaped scaling spots on the trunk, arms or legs.
Occurs mostly in the skin fold areas of the groin, buttocks and breasts, which is worsened by friction and sweating. This type of psoriasis is commonly triggered by a fungal infection.
This type of Psoriasis is rare and is characterized by pus-filled blisters which are clearly defined. It can occur in small areas on the hand palm of foot soles but can also be widespread over the body.
Can be acute (short-lived) or chronic (long-term) – and covers the entire body with a rash which burns and itches intensely, accompanied with peeling. This type is the least common
WHEN TO SEE A DOCTORBack to top
There are a number of treatments available to soothe psoriasis and make flare-ups bearable, however if you suspect you or a loved one may suffer from psoriasis, talk to your healthcare provider or seek medical attention if the condition:
- Affects you severely and/or is widespread over the body
- Makes you feel uncomfortable and causes pain
- Concerns you about your skin’s appearance
- Doesn’t get better with treatment
CAUSESBack to top
Psoriasis is a skin condition that affects many and is thought to be an immune system problem – which causes skin cells to grow much faster than usual. The most common type of psoriasis, plaque psoriasis, results in the rapid turnover of skin cells resulting in dry, scaly patches.
The cause of psoriasis is not fully understood – but what happens is that the body triggers infection-fighting cells to attack healthy skin tissue by mistake resulting in the various types of psoriasis. Psoriasis is not contagious, and researchers believe that people affected by this condition are influenced by their genetics and environmental factors.
TRIGGERSBack to top
Many people who are prone to suffer from this condition may be free of symptoms for many years, until an infection or disease is triggered by some environmental factors, which results in what we call a ‘flare up’. These triggers can be caused by:
- The weather – especially cold and dry conditions
- Infections like skin infections or strep throat
- Severe sunburn or injury to the skin like cuts, scrapes or bug bites
- Heavy alcohol consumption
- Exposure to second hand smoke and smoking
- Immediate withdrawal of oral or injected corticosteroids
RISK FACTORSBack to top
Psoriasis is a common occurrence, and anyone can develop it, with about a third of cases beginning in childhood.
The risk of developing this disease can increase with the following factors:
- Your family history
- Genetics play a big role, and it is common for individuals to get the disease if they have members of the family suffering from psoriasis too.
- Smoking tobacco can increase the risk of developing psoriasis, and also the severity of the condition
COMPLICATIONSBack to top
If you do have psoriasis, your risk to develop other conditions are greater, these can be:
- Temporary skin colour changes where plaques have healed (post-inflammatory hypopigmentation or hyperpigmentation)
- Eye conditions like conjunctivitis, blepharitis and uveitis
- Psoriatic Arthritis – swelling, pain and stiffness around the joints
- Obesity and Type 2 Diabetes
- High Blood Pressure
- Cardiovascular disease
- Other auto-immune diseases like celiac, sclerosis, Crohn’s and inflammatory bowel disease
- Mental health problems such as depression and low self-esteem
TREATMENTBack to top
These include treatments like Corticosteroids, synthetic forms of vitamin D, Retinoinds, Calcineurin inhibitors and Salicylic acid.
Topical medications are a treatment for mild to moderate psoriasis. They are available as ointments, creams, foams, lotions and washes. The cream, gel, or ointment is usually recommended for sensitive areas, such as the face or folds, and for treating widespread patches.
Topical treatments are usually applied once a day during flareups, and on alternate days during remission.
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