Lawrence F. Eichenfield, MD
Obesity appears to be a common comorbidity in pediatric patients with psoriasis. It is uncertain if the cardiovascular risks seen in adults with psoriasis is fundamentally related to obesity, skin inflammation, or other factors. It is reasonable to discuss these issues with families of children with psoriasis, though much research is needed about long-term risks and modifying them.
Regarding psoriatic arthritis (PsA) in children, consider asking children with psoriasis about morning stiffness, as this can be a sign of PsA. Pediatric psoriasis is typically treated with topical corticosteroids and Vitamin-D analogues; however, clinicians should not forget the appropriate placement of light therapy (NB-UVB is the most studied), which can be very effective. The National Psoriasis Foundation has a pediatric site that is kid-friendly and provides much needed information and resources.
Systemic treatment is appropriate for severe psoriasis in children and adolescents, though it can be much work to have third party payers cover the costs of systemic therapies including biologic agents as there are no specifically approved systemic treatments for children and adolescents with psoriasis.
In summary, there is a fair amount of new information for both Atopic Dermatitis and psoriasis and, in the future, hopefully more treatments will become available for pediatric patients.