Kids With Psoriasis Get Inconsistent Care

WEDNESDAY, Sept. 21 (HealthDay News) — How children are treated for psoriasis may depend on whether they see a pediatrician, dermatologist or internist, a new study suggests.

About 1 percent of children from birth to age 18 are affected by psoriasis, a skin condition that can lead to patches of itchy, flaky, dry skin.

Researchers from University of California, San Francisco School of Medicine and colleagues examined records from physicians on their pediatric psoriasis patients who scheduled visits over the course of nearly three decades.

Of 3.8 million visits, about 63 percent of kids saw a dermatologist; 17 percent saw a pediatrician; and 14 percent went to an internist.

Researchers found that pediatricians, dermatologists and internists often take different approaches to how they treat children with psoriasis, including what types of medication they use and how strong it is.

“Management of psoriasis in children can be challenging,” the study’s authors wrote, “owing to a paucity of data and lack of standardized guidelines specific to the pediatric population.”

Most of the children in the study were given topical corticosteroids, particularly betamethasone.

Dermatologists and internists were most likely to prescribe strong steroids. The potency was roughly the same regardless of a child’s age. Pediatricians, on the other hand, most often prescribed the topical immunosuppressant tacrolimus.

Severe cases of psoriasis were sometimes treated with phototherapy and oral medication.

The same number of boys and girls were treated for the condition. The vast majority of them, 93 percent, were white. Nearly half of the patients ranged in age from 13 to 18; 35 percent were 8 to 12 years old; and 18 percent were younger than 7 years old.

The study is published online in the Archives of Dermatology.

The researchers expressed concern about the lack of uniformity in treatment for psoriasis among children, particularly that strong topical corticosteroids are so often prescribed for young children.

“In our experience, the highest potency topical corticosteroids are not commonly needed for psoriasis in young children,” the researchers wrote. They concluded treatment guidelines should be established for pediatric psoriasis.

More information

The National Psoriasis Foundation has more on psoriasis in children.

– Mary Elizabeth Dallas

SOURCE: JAMA/Archives, news release, September 19, 2011

Last Updated: Sept. 21, 2011