Efficacy and safety of treatments for childhood psoriasis: a systematic literature review.
BACKGROUND
Evidence-based recommendations for therapeutic decision making in childhood psoriasis are lacking.


OBJECTIVE
We sought to systematically review all available literature concerning treatment efficacy and safety in childhood psoriasis and to propose a recommendation for topical and systemic treatment of childhood psoriasis.


METHODS
Databases searched were PubMed, EMBASE, and the Cochrane Controlled Clinical Trial Register. All studies reporting on efficacy and safety of all treatment options in childhood psoriasis were obtained and a level of evidence was determined.


RESULTS
Literature search revealed 2649 studies, of which 64 studies met the inclusion criteria. The majority of topical and systemic therapies given in childhood psoriasis are efficacious. Short-term side effects were usually mild; long-term side effects were not described.


CONCLUSIONS
Most conclusions formulated are not based on randomized controlled trials.


CONCLUSIONS
A rough summary of the proposed algorithm is as follows: first, calcipotriene with/without topical corticosteroids, followed by dithranol. Methotrexate is considered to be the systemic treatment of choice.
de Jager
Michelle E A
ME
Department of Dermatology, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands. M.deJager@derma.umcn.nl
de Jong
Elke M G J
EM
van de Kerkhof
Peter C M
PC
Seyger
Marieke M B
MM
D000875:Anthralin / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D065095:Calcineurin Inhibitors; D002117:Calcitriol / Q000031:analogs & derivatives / Q000627:therapeutic use; D002648:Child; D003879:Dermatologic Agents / Q000627:therapeutic use; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D008727:Methotrexate / Q000627:therapeutic use; D011565:Psoriasis / Q000188:drug therapy*
D000900:Anti-Bacterial Agents; D065095:Calcineurin Inhibitors; D003879:Dermatologic Agents; D005938:Glucocorticoids; C055085:calcipotriene; D002117:Calcitriol; D000875:Anthralin; D008727:Methotrexate