Psoriasis Research
Psoriasis in
Children
What
is Psoriasis?
Psoriasis
is a common skin condition that affects over a
million-and-a-hall people in this country, and approximately eighty
million Worldwide. Psoriasis is in simple terms only a vast acceleration
of the usual replacement process of the skin. Normally a skin cell matures
in twenty-one to forty days during its passage to the surface where a
constant invisible shedding of dead cells, as scales, takes place.
Psoriatic cells, however, are believed to turn over in two or three days
and in such chaotic profusion that even live cells reach the surface and
accumulate with the dead ones in visible layers.
It appears as raised red patches of skin covered
with silvery scales. It can occur in any part of the body, although knees,
elbows and the scalp are the usual sites. There is often accompanying
irritation. It cannot be caught from other people, nor can it be
transferred from one part of the body to another.
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Known
Causes
Basic causes
are as yet unknown. Hereditary factors are thought to play an important
part and much research is being carried out into this aspect. It does,
however, appear as if a genetic tendency is triggered off by such things
as injury, throat infection (particularly in children), certain drugs and
both physical and emotional stress.
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Do
babies have it?
It is exceedingly rare for babies to have Psoriasis,
particularly when there is no history in the family. Rashes in the napkin
area are sometimes thought to be Psoriasis, i.e. those provoked by a
thrush infection. However, occasionally rashes appearing in a baby of a
psoriatic family may be true Psoriasis, the child later developing typical
lesions.
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What
is Guttate Psoriasis?
Psoriasis of the usual type rarely begins before the
age of about four or five. The onset is often an outbreak of what is
called Guttate Psoriasis, gutta being the Latin word for a drop. Guttate
Psoriasis consists of many very small scaly patches affecting the trunk,
limbs and sometimes the scalp. There may be a few rather larger patches,
or such patches may in time develop. This type of rash often follows an
infection, often one caused by streptococci in the throat; usually the
rash clears well (in several weeks or months), but in some children
patches will linger on indefinitely.
If a child has a tendency to tonsillitis, the
rash may come back with each attack. Fortunately, serious involvement and
the linked form of arthritis are exceedingly rare.
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Inheritance
Research is beginning to unravel the genetic aspects
of psoriasis. Eventually it will be possible to identify those who have a
tendency to it before they actually develop signs of it. Since onset may
be late in life and the actual rash minimal, many people will have died
without being noted as sufferers.
Having one parent with Psoriasis will increase
the chance of a child’s developing Psoriasis. If both parents have it,
the chance will increase further. It is also probable that with such a
background the psoriasis will tend to arise fairly early in life.
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Conventional
Treatment
Treatment must steer a course between doing too
little and too much. Too little, and worthwhile improvement is denied, too
much, and the life of the child and the family is burdened by it. Most
treatments in use for adults also help children; for example, bland
ointments and creams, tar preparations, dithranol, steroid creams and
ultra-violet light. It is most important that advice given by Doctors and
the manufacturers of treatments on the use of all treatments should be
kept to. Any doubt should quickly be discussed. Antihistamine tablets or
syrups often help if the itching is severe. Sometimes a short hospital
stay is a useful weapon in clearing the outbreak and teaching child and
parent some of the techniques used in applying creams and dressings.
Sometimes it will be possible for these methods
to be demonstrated, in combination with general guidance and support, in
out-patient visits to a ward or a clinic. The more ‘dramatic’
treatments for Psoriasis, such as methotrexate, acitretin and PUVA are not
given to children except under very special circumstances.
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Immunisation
All the usual
immunisation procedures may safely be given, but it is worth remembering
that a patch of psoriasis may come up at any site where the skin has been
‘injured’, for example following inimunisation with BCG.
Source: - The Psoriasis Association
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