S. Kapila, E. Hong, G. Fischer
Introduction: Psoriasis (Pso) in children may be confused clinically with atopic dermatitis (AD) and may co-exist with it. The aim of this study was to determine historical and clinical features which are different in paediatric Pso and AD and to describe children who have features of both: psoriasis-dermatitis overlap (PD).
Methods: Children with features of psoriasis or eczema or
both attending paediatric outpatients and private rooms
were evaluated. Data were collected from 170 consecutive
children aged less than 12 years between July 2011 and
November 2011. Participants were classiﬁ ed by a described
criteria as having Pso (N = 64), AD (N = 62) or PD (N = 44).
Results: Only 9.4% of children with Pso were correctly diagnosed by the referring doctor. Children with Pso as opposed to AD were more likely to have had a history of scaly scalp and nappy rash in infancy, a family history of psoriasis, current scalp and periauricular rashes, deﬁ ned, patchy plaque morphology and papulosquamous rashes not typical of adult psoriasis on extensor elbows and knees. Children with PD had features of both but presented most often as typical paediatric psoriasis combined with ﬂ exural eczema. Children with Pso and PD responded well to speciﬁ c treatment strategies for psoriasis, including potent topical corticosteroids (TCS), calcipotriol and phototherapy. Both Pso and PD tended to require more potent TCS than AD to achieve disease suppression.
Conclusion: We found that Pso and PD in children both differ clinically from AD and have identiﬁ ed historical and clinical features that characterize childhood Pso.