title: Management of psoriasis in adolescence.
abstract: Psoriasis is a chronic inflammatory cutaneous disorder affecting 2%-4% of the world's population. The prevalence of the disease in childhood and adolescence ranges between 0.5% and 2%. The management of psoriasis in adolescence is an intriguing and complicated task. Given the paucity of officially approved therapies, the very limited evidence-based data from randomized controlled trials, and the absence of standardized guidelines, physicians must rely on published experience from case reports both from the field of dermatology as well as from the application of these drugs for other pediatric conditions coming from the disciplines of rheumatology, gastroenterology, and oncology. Psoriatic adolescents deal with a potentially disfiguring and lifelong disease that could permanently impair their psychological development. It must be clarified to them that psoriasis does not have a permanent cure, and therefore the main goal of treatments is to establish disease control and prolonged periods between flares. The majority of adolescents suffer from mild psoriasis, and thus they are treated basically with topical treatment modalities. Phototherapy is reserved for adolescents with mild-to-moderate plaque disease and/or guttate psoriasis when routine visits to specialized centers do not create practical problems. Systemic agents and biologics are administered to patients with moderate-to-severe plaque psoriasis, pustular psoriasis, or erythrodermic psoriasis.
authors.affiliation: First Department of Dermatology-Venereology, Aristotle University Medical School, Thessaloniki, Greece.
authors.forename: Christina
authors.initials: C
authors.lastname: Fotiadou
authors.affiliation: First Department of Dermatology-Venereology, Aristotle University Medical School, Thessaloniki, Greece.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Lazaridou
authors.affiliation: First Department of Dermatology-Venereology, Aristotle University Medical School, Thessaloniki, Greece.
authors.forename: Demetrios
authors.initials: D
authors.lastname: Ioannides
keywords: adolescent psoriasis; biologic agents; pediatric psoriasis; systemic treatment; treatment
references.citation: N Engl J Med. 2008 Aug 21;359(8):810-20
references.pmid: 18716298
references.citation: J Invest Dermatol. 2013 Feb;133(2):377-85
references.pmid: 23014338
references.citation: Skin Therapy Lett. 2012 Jan;17(1):5-7
references.pmid: 22358228
references.citation: Clin Exp Dermatol. 2001 Jun;26(4):314-20
references.pmid: 11422182
references.citation: J Am Acad Dermatol. 2010 Nov;63(5):762-8
references.pmid: 20605256
references.citation: J Eur Acad Dermatol Venereol. 2006 Jul;20(6):651-6
references.pmid: 16836490
references.citation: Skin Therapy Lett. 2013 Feb;18(2):1-4
references.pmid: 23508772
references.citation: Curr Med Res Opin. 1983;8(6):446-50
references.pmid: 6342960
references.citation: J Am Acad Dermatol. 1997 Feb;36(2 Pt 1):203-8
references.pmid: 9039169
references.citation: Dermatol Online J. 2005 Dec 01;11(3):11
references.pmid: 16409907
references.citation: Br J Dermatol. 2010 Mar;162(3):633-6
references.pmid: 19922529
references.citation: Br J Dermatol. 1998 Oct;139(4):754-5
references.pmid: 9892934
references.citation: Arch Dermatol. 2012 Jan;148(1):66-71
references.pmid: 21931013
references.citation: Arch Dermatol. 2001 Nov;137(11):1532-3
references.pmid: 11708969
references.citation: Int J Dermatol. 2007 Mar;46(3):320-2
references.pmid: 17343596
references.citation: J Am Acad Dermatol. 2010 Jun;62(6):979-87
references.pmid: 19962785
references.citation: J Am Acad Dermatol. 2003 Aug;49(2):171-82; quiz 183-6
references.pmid: 12894062
references.citation: Int J Dermatol. 2004 Sep;43(9):654-8
references.pmid: 15357744
references.citation: J Eur Acad Dermatol Venereol. 2007 Nov;21(10):1337-43
references.pmid: 17958839
references.citation: Pediatr Dermatol. 2000 May-Jun;17(3):174-8
references.pmid: 10886746
references.citation: Pediatr Dermatol. 2004 Jan-Feb;21(1):87-8
references.pmid: 14871337
references.citation: J Dtsch Dermatol Ges. 2010 Oct;8(10):812-8
references.pmid: 20738459
references.citation: Br J Dermatol. 2010 Nov;163(5):1099-101
references.pmid: 20716218
references.citation: Ther Clin Risk Manag. 2009;5:849-56
references.pmid: 19898649
references.citation: Pediatr Dermatol. 2007 May-Jun;24(3):332-3
references.pmid: 17542899
references.citation: Arch Dermatol. 1995 Aug;131(8):961-2
references.pmid: 7632076
references.citation: Br J Dermatol. 2004 Oct;151(4):912-6
references.pmid: 15491438
references.citation: J Am Acad Dermatol. 2010 Jun;62(6):1013-30
references.pmid: 19900732
references.citation: J Am Acad Dermatol. 2008 Sep;59(3):448-54, 454.e1
references.pmid: 18539358
references.citation: Br J Dermatol. 2011 May;164(5):1101-3
references.pmid: 21418172
references.citation: Pediatr Dermatol. 2011 Mar-Apr;28(2):195-7
references.pmid: 21504452
references.citation: Ann Rheum Dis. 2009 May;68(5):635-41
references.pmid: 18413443
references.citation: Pediatr Dermatol. 2007 Jan-Feb;24(1):76-80
references.pmid: 17300658
references.citation: N Engl J Med. 2008 Jan 17;358(3):241-51
references.pmid: 18199863
references.citation: Pediatr Dermatol. 2001 May-Jun;18(3):246-8
references.pmid: 11438009
references.citation: Br J Dermatol. 2006 Jul;155(1):145-51
references.pmid: 16792766
references.citation: Semin Cutan Med Surg. 2010 Mar;29(1):20-7
references.pmid: 20430304
references.citation: J Am Acad Dermatol. 2005 Oct;53(4):713-6
references.pmid: 16198804
references.citation: Semin Immunol. 2009 Dec;21(6):318-27
references.pmid: 19446472
references.citation: Pediatr Dermatol. 2009 Jan-Feb;26(1):23-7
references.pmid: 19250400
references.citation: Pediatr Int. 2006 Dec;48(6):525-30
references.pmid: 17168968
references.citation: J Pediatr Gastroenterol Nutr. 2007 Feb;44(2):265-7
references.pmid: 17255842
references.citation: Pediatr Dermatol. 1994 Sep;11(3):271-3
references.pmid: 7971565
references.citation: J Dermatolog Treat. 2005;16(5-6):350-2
references.pmid: 16428160
references.citation: J Am Acad Dermatol. 2000 May;42(5 Pt 2):885-7
references.pmid: 10767696
references.citation: J Am Acad Dermatol. 2009 Feb;60(2):218-24
references.pmid: 19022533
references.citation: Eur J Dermatol. 2011 Jan-Feb;21(1):117-8
references.pmid: 21233068
references.citation: Pediatr Dermatol. 2011 May-Jun;28(3):349-50
references.pmid: 21371112
references.citation: Pediatr Dermatol. 2001 May-Jun;18(3):188-98
references.pmid: 11437997
references.citation: Br J Dermatol. 2006 Jan;154(1):181-3
references.pmid: 16403117
references.citation: Dermatol Clin. 2013 Apr;31(2):267-88
references.pmid: 23557655
references.citation: Dermatology. 2006;213(4):350-2
references.pmid: 17135745
references.citation: Br J Dermatol. 2009 Nov;161(5):987-1019
references.pmid: 19857207
references.citation: Pediatr Dermatol. 2004 May-Jun;21(3):283-4
references.pmid: 15165222
references.citation: J Am Acad Dermatol. 2006 Mar;54(3 Suppl 2):S126-8
references.pmid: 16488325
references.citation: Adv Dermatol. 2008;24:125-69
references.pmid: 19256308
references.citation: J Am Acad Dermatol. 2011 Jul;65(1):137-74
references.pmid: 21306785
references.citation: Int J Dermatol. 1994 Nov;33(11):808-10
references.pmid: 7822090
references.citation: J Eur Acad Dermatol Venereol. 2007 Jul;21(6):762-5
references.pmid: 17567304
references.citation: J Dermatolog Treat. 2003 Jun;14(2):113-8
references.pmid: 12775319
references.citation: Br J Dermatol. 2007 Aug;157(2):344-9
references.pmid: 17553037
references.citation: Arthritis Rheum. 2008 May;58(5):1496-504
references.pmid: 18438876
references.citation: Pediatr Dermatol. 2008 Mar-Apr;25(2):184-8
references.pmid: 18429775
references.citation: Pediatr Dermatol. 2003 Jan-Feb;20(1):11-5
references.pmid: 12558839
references.citation: Pediatr Dermatol. 1999 Jul-Aug;16(4):321-5
references.pmid: 10469423
references.citation: Clin Exp Dermatol. 2009 Apr;34(3):295-8
references.pmid: 19175782
references.citation: Pediatr Dermatol. 2006 Jan-Feb;23(1):67-71
references.pmid: 16445417