title: Therapy of psoriasis in childhood and adolescence - a German expert consensus.
abstract: Psoriasis of childhood shows an annual prevalence of 0.71 % and accordingly has to be regarded as a frequent chronic inflammatory skin disorder of this age. The impact on the quality of life as well as development of the afflicted children and their parents is evident. On the other side, therapy is demanding with regard to the specific juvenile metabolism, physical development and skin penetration of topical drugs. Long-term treatment at an early age has to be critically judged regarding the chronicity of the disease. Topical corticosteroids, alternatively dithranol may be used first-line, followed by vitamin D derivatives. A combination with UV-light, preferably UV-B, has to be decided on an individual basis. Systemic treatment may be initiated in recalcitrant disease with methotrexate and cyclosporine where long-term experience is available from juvenile rheumatology and transplantation medicine. Alternatively fumaric acid esters or retinoids are available. Rehabilitation procedures will help the children and their parents to cope with the disease and its treatment. The different treatment options are presented here as a German expert consensus, as clinical studies are hardly available and only a few therapeutics are licensed for this age. In any case the therapy has to be individually planned and decided together with the patients and their parents to gain maximal safety, comfort and success.
authors.affiliation: Department of Dermatology, University Hospital Erlangen, Germany. michael.sticherling@uk-erlangen.de
authors.forename: Michael
authors.initials: M
authors.lastname: Sticherling
authors.forename: Matthias
authors.initials: M
authors.lastname: Augustin
authors.forename: Wolf-Henning
authors.initials: WH
authors.lastname: Boehncke
authors.forename: Enno
authors.initials: E
authors.lastname: Christophers
authors.forename: Silja
authors.initials: S
authors.lastname: Domm
authors.forename: Harald
authors.initials: H
authors.lastname: Gollnick
authors.forename: Kristian
authors.initials: K
authors.lastname: Reich
authors.forename: Ulrich
authors.initials: U
authors.lastname: Mrowietz
mesh_terms: D000284:Administration, Oral; D000287:Administration, Topical; D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000008:administration & dosage* / Q000009:adverse effects / Q000493:pharmacokinetics; D000875:Anthralin / Q000008:administration & dosage* / Q000009:adverse effects / Q000493:pharmacokinetics; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage* / Q000009:adverse effects / Q000493:pharmacokinetics; D002648:Child; D003430:Cross-Sectional Studies; D003879:Dermatologic Agents / Q000008:administration & dosage* / Q000009:adverse effects / Q000493:pharmacokinetics; D005858:Germany; D006801:Humans; D011565:Psoriasis / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology; D012869:Skin Absorption / Q000187:drug effects; D017592:Skin Care / Q000379:methods; D014508:Urea / Q000008:administration & dosage / Q000009:adverse effects / Q000493:pharmacokinetics
chemical_list: D000305:Adrenal Cortex Hormones; D000893:Anti-Inflammatory Agents; D003879:Dermatologic Agents; D014508:Urea; D000875:Anthralin