The most common form, plaque psoriasis, appears as raised red lesions covered with a silvery film. It often occurs on the elbows, knees, and lower back, but can appear on any part of the body. The plaques may be itchy or painful. Psoriasis is a chronic condition that usually first strikes in the teen years, but 20,000 children in the U.S. under age 10 will be diagnosed with psoriasis each year. Guttate psoriasis, another form that's more common in children, is usually triggered by a bacterial infection (often strep throat) and appears as smaller (up to 1 cm), scaly patches on the trunk, limbs and scalp. Though rare in babies, psoriasis is sometimes misdiagnosed as diaper rash or cradle cap.
Normally, the life of a skin cell is about 28 days. Psoriasis is an autoimmune disorder that causes a person to develop these cells at a faster rate than normal, leaving a buildup at the skin’s surface. There’s a strong genetic component: about 1 in 10 kids with a parent with psoriasis will develop it too.
A doctor can diagnose psoriasis by examining the lesions and learning about a child’s family history of the disease. A skin biopsy, which involves removing a small piece of affected skin for examination under a microscope for confirmation, may also be done in the doctor's office with the help of local anesthetic.
Because up to half of psoriasis cases in kids follow an infection, particularly strep throat, children who are at risk for the condition should take extra care to wash or sanitize their hands regularly, and avoid people who are sick.
There’s no cure for psoriasis, though mild, topical prescription steroid creams can help lesions heal more quickly and control outbreaks. If the psoriasis was triggered by an infection, your child might also need a course of antibiotics. You can ask your doctor about other medications; there are some that are prescribed for kids even though they have not yet received FDA approval for children under 18.
Sunlight can speed healing. Talk to your child's doctor about safe ways to expose her to the sun (sunscreen should still be used on unaffected skin), and about UVB sunlight therapy, which can be administered in a physician’s office. Avoid sunburns, which can trigger a bad flare-up of psoriasis. Oatmeal baths and aloe vera gel might help soothe itchy, painful skin.