Scalp involvement is very common in children. Thick, scaling, raised lesions can involve either localized areas of the scalp, such as behind the ears and/or along the hairline, or the entire scalp. This can result in the shedding of white scales from the scalp, commonly mistaken for dandruff.
The genitals are also frequently affected in children, particularly babies. The penis, groin, buttock crease, and labia are common sites of involvement. The fingernails and toenails might also be involved. The nails may become pitted or rough, and the distal part of the nail can become quite thick and crumbly. Lifting of the nail from the surrounding skin can also occur (onycholysis). Occasionally in children, all twenty nails may be involved.
 |
| Psoriasis Children Pictures |
Other forms of psoriasis seen in adults, such as erythrodermic and pustular psoriasis, are less common in childhood. With treatment, psoriasis can be controlled effectively in children.
Devon is an active, happy, 2-year-old toddler who was referred to me by her family doctor because of a recurrent diaper rash. The rash had started on her buttocks a year earlier after an episode of diarrhea. Subsequently, she developed a red, scaly rash, which healed after treatment with a mild topical steroid cream. However, it recurred in the genital area and had been persistent for the past four to five months. There is a family history of psoriasis involving Devon's father and grandfather. Her father has more extensive involvement on the arms and legs, which has been ongoing for more than ten years, with a history of psoriatic arthritis.
Recently, Devon also developed a red scaly area on the left eyelid; her parents wondered if there was any relationship to the diaper rash and were concerned about the potential for scarring. They are worried - as Devon tends to scratch these areas frequently - this condition could worsen when she is older. At this point, they were using only zinc oxide cream to treat the areas in the diaper region.
Devon is an otherwise completely healthy girl who is very active and has had normal growth and development. She likes to play with her older sister, who is 3 1/2 years old, and there has been no limitation, because of this condition, on her activities.
When I examined Devon, I detected very localized with only the presence of redness and minimal scaling on the genitals and the lower abdomen, as well as a very small amount of scaling and redness on the left upper eyelid.
I explained to Devon's parents that the rash in the diaper area and on the eyelid was childhood posriasis, and that the involvement of the diaper area is often seen in young children. I started Devon on treatment with hydrocortisone 1 percent ointment rather than the cream as an ointment is more moisturzing.
 |
| Psoriasis Children Pictures |
In addition, I prescribed one of the newer nonsteroidal treatments, pimecrolimus 1 percent cream, for use on the face and also, as needed, for the genital area. Nonsteroidal therapies can avoid the side effects of steroids in the skin when used over longer periods. They are currently under investigation for treatment of psoriasis in delicate skin. It is important, however, to recognize that topical steroids can be used quite safely for shorter periods in delicate areas or on other body areas for longer periods.
Devon completely cleared with this treatment and subsequently has had only occasional mild involvement in these areas. To find out more, you can check out Psoriasis Children Pictures.