An expert panel recommended guidelines for patients with pediatric psoriasis, including routine screening and identification of certain risk factors for associated comorbidities, according to a consensus statement published in JAMA Dermatology.
The panel used PubMed to conduct a literature review for psoriasis and comorbidities to identify 153 manuscripts, including 26 involving pediatric patients, between 1999 and 2015. Quality of evidence was measured by Lawrence F. Eichenfield, MD, chief of pediatric and adolescent dermatology, Rady Children’s Hospital San Diego, and fellow experts in psoriasis, pediatric dermatology, pediatric rheumatology, pediatric gastroenterology, pediatric endocrinology and adult and pediatric cardiology by using the patient-centered Strength of Recommendation Taxonomy (SORT) method.
Lawrence F. Eichenfield
The strength of the panel’s recommendations was SORT level C due to a limited number of pediatric studies published on the topics.
The recommendations included pediatric screening for overweight or obesity, diabetes, dyslipidemia, hypertension, psoriatic arthritis, depression, anxiety and substance abuse. Researchers recommended comorbidity background awareness for polycystic ovary syndrome, gastrointestinal diseases, uveitis and quality of life. They also noted that health care providers should consider the existence of comorbidities before beginning systemic therapies for psoriasis.
“The majority of recommendations coincide with those endorsed by the American Academy of Pediatrics for the general pediatric patient but with added attention to signs and symptoms of arthritis, depression and anxiety,” the panel wrote.
“These mainly consensus-based recommendations provide a starting point for screening that will be refined as more is learned,” the panel concluded. “As studies further detail the comorbidity risks in children, there may be a need to further stratify screening (eg, by age group, disease subtype, severity). It will also be important to assess the effectiveness of early detection and intervention in preventing future complications.” – by Bruce Thiel
Disclosure: The researchers report no relevant financial disclosures.