Skip to main content
Erschienen in: Der Hautarzt 4/2015

01.04.2015 | Leitthema

Psoriasis vulgaris bei Kindern und Jugendlichen

Pathogenese, Klinik und Therapie

verfasst von: Prof. Dr. P.H. Höger, H. Hamm

Erschienen in: Die Dermatologie | Ausgabe 4/2015

Einloggen, um Zugang zu erhalten

Zusammenfassung

Hintergrund

Die Prävalenz der Psoriasis vulgaris steigt im Kindesalter linear von 0,12 % im Säuglingsalter bis auf 1,2 % bei 17-Jährigen. Es handelt sich um eine polygen determinierte Erkrankung, deren Manifestation und Ausprägungsgrad durch äußerliche Faktoren getriggert und durch Begleiterkrankungen wie Adipositas bzw. metabolisches Syndrom, rheumatische Erkrankungen und chronisch entzündliche Darmerkrankungen beeinflusst werden können.

Klinik

Die klinische Manifestation ist vielfältig. Schwere Verläufe sind durch Erythrodermie, ausgedehnte Pustulation oder Arthropathie gekennzeichnet.

Therapie

Die Behandlung der Psoriasis orientiert sich an der klinischen Symptomatik (Art, Lokalisation und Ausmaß der Hautveränderungen), am Alter des Patienten sowie an eventuellen Begleiterkrankungen und folgt hinsichtlich der topischen bzw. systemischen Therapie einem Stufenschema.
Literatur
1.
Zurück zum Zitat Al-Mutairi N, Manchanda Y, Nour-Eldin O (2007) Nail changes in childhood psoriasis: a study from Kuwait. Pediatr Dermatol 24:7–10CrossRefPubMed Al-Mutairi N, Manchanda Y, Nour-Eldin O (2007) Nail changes in childhood psoriasis: a study from Kuwait. Pediatr Dermatol 24:7–10CrossRefPubMed
2.
Zurück zum Zitat Augustin M, Glaeske G, Radtke MA et al (2010) Epidemiology and comorbidity of psoriasis in children. Brit J Dermatol 162:633–636CrossRef Augustin M, Glaeske G, Radtke MA et al (2010) Epidemiology and comorbidity of psoriasis in children. Brit J Dermatol 162:633–636CrossRef
3.
Zurück zum Zitat Augustin M, Reich K, Glaeske G et al (2013) Arzneimittelversorgung von Kindern mit Psoriasis in Deutschland. J Dtsch Dermatol Ges 11:751–755PubMed Augustin M, Reich K, Glaeske G et al (2013) Arzneimittelversorgung von Kindern mit Psoriasis in Deutschland. J Dtsch Dermatol Ges 11:751–755PubMed
4.
Zurück zum Zitat Balak DM, Oostveen AM, Bousema MT et al (2013) Effectiveness and safety of fumaric acid esters in children with psoriasis: a retrospective analysis of 14 patients from The Netherlands. Br J Dermatol 168:1343–1347CrossRefPubMed Balak DM, Oostveen AM, Bousema MT et al (2013) Effectiveness and safety of fumaric acid esters in children with psoriasis: a retrospective analysis of 14 patients from The Netherlands. Br J Dermatol 168:1343–1347CrossRefPubMed
5.
Zurück zum Zitat Becker L, Tom WL, Eshagh K et al (2014) Excess adiposity preceding pediatric psoriasis. JAMA Dermatol 150:573–574CrossRefPubMed Becker L, Tom WL, Eshagh K et al (2014) Excess adiposity preceding pediatric psoriasis. JAMA Dermatol 150:573–574CrossRefPubMed
6.
Zurück zum Zitat Benoit S, Hamm H (2009) Psoriasis im Kindes- und Jugendalter. Klinik und Therapie. Hautarzt 60:100–108CrossRefPubMed Benoit S, Hamm H (2009) Psoriasis im Kindes- und Jugendalter. Klinik und Therapie. Hautarzt 60:100–108CrossRefPubMed
7.
Zurück zum Zitat Bergboer JGM, Oostveen AM, de Jager MEA et al (2012) Paediatric-onset psoriasis is associated with ERAP1 and IL23R loci, LCE3C_LCE3B deletion and HLA-C*06. Brit J Dermatol 167:922–925CrossRef Bergboer JGM, Oostveen AM, de Jager MEA et al (2012) Paediatric-onset psoriasis is associated with ERAP1 and IL23R loci, LCE3C_LCE3B deletion and HLA-C*06. Brit J Dermatol 167:922–925CrossRef
8.
Zurück zum Zitat Boccardi D, Menni S, La Vecchia C et al (2009) Overweight and childhood psoriasis. Br J Dermatol 161:484–486CrossRefPubMed Boccardi D, Menni S, La Vecchia C et al (2009) Overweight and childhood psoriasis. Br J Dermatol 161:484–486CrossRefPubMed
9.
Zurück zum Zitat Cather JC (2014) Psoriasis in children and women: addressing some special needs. Semin Cutan Med Surg 33(Suppl 2):42–44 Cather JC (2014) Psoriasis in children and women: addressing some special needs. Semin Cutan Med Surg 33(Suppl 2):42–44
10.
Zurück zum Zitat Chao PH, Cheng YW, Chung MY (2009) Generalized pustular psoriasis in a 6-week-old infant. Pediatr Dermatol 26:352–354CrossRefPubMed Chao PH, Cheng YW, Chung MY (2009) Generalized pustular psoriasis in a 6-week-old infant. Pediatr Dermatol 26:352–354CrossRefPubMed
11.
Zurück zum Zitat Chiam LYT, de Jager MEA, Giam YC et al (2011) Juvenile psoriasis in European and Asian children: similarities and differences. Br J Dermatol 164:1101–1103CrossRefPubMed Chiam LYT, de Jager MEA, Giam YC et al (2011) Juvenile psoriasis in European and Asian children: similarities and differences. Br J Dermatol 164:1101–1103CrossRefPubMed
12.
Zurück zum Zitat Choy DF, Hsu DK, Seshasayee D et al (2012) Comparative transcriptomic analyses of atopic dermatitis and psoriasis reveal shared neutrophilic inflammation. J Allergy Clin Immunol 130:1335–1343CrossRefPubMedCentralPubMed Choy DF, Hsu DK, Seshasayee D et al (2012) Comparative transcriptomic analyses of atopic dermatitis and psoriasis reveal shared neutrophilic inflammation. J Allergy Clin Immunol 130:1335–1343CrossRefPubMedCentralPubMed
13.
Zurück zum Zitat Davidovici BB, Sattar N, Prinz JC et al (2010) Psoriasis and systemic inflammatory diseases: Potential mechanistic link between skin disease and co-morbid conditions. J Invest Dermatol 130:1785–1796CrossRefPubMed Davidovici BB, Sattar N, Prinz JC et al (2010) Psoriasis and systemic inflammatory diseases: Potential mechanistic link between skin disease and co-morbid conditions. J Invest Dermatol 130:1785–1796CrossRefPubMed
14.
Zurück zum Zitat van Geel MJ, Oostveen AM, Hoppenreijs EP et al (2014) Methotrexate in pediatric plaque-type psoriasis: long-term daily clinical practice results from the Child-CAPTURE registry. J Dermatolog Treat 8:1–25 van Geel MJ, Oostveen AM, Hoppenreijs EP et al (2014) Methotrexate in pediatric plaque-type psoriasis: long-term daily clinical practice results from the Child-CAPTURE registry. J Dermatolog Treat 8:1–25
15.
Zurück zum Zitat Gudjonsson JE, Thorarinsson AM, Sigurgeirsson B et al (2003) Streptococcal throat infections and exacerbation of chronic plaque psoriasis: a prospective study. Br J Dermatol 149:530–534CrossRefPubMed Gudjonsson JE, Thorarinsson AM, Sigurgeirsson B et al (2003) Streptococcal throat infections and exacerbation of chronic plaque psoriasis: a prospective study. Br J Dermatol 149:530–534CrossRefPubMed
16.
Zurück zum Zitat Hajdarbegovic E, Nijsten T, Westgeest A et al (2013) Decreased prevalence of atopic features in patients with psoriatic arthritis, but not in psoriasis vulgaris. J Am Acad Dermatol 68:270–277CrossRefPubMed Hajdarbegovic E, Nijsten T, Westgeest A et al (2013) Decreased prevalence of atopic features in patients with psoriatic arthritis, but not in psoriasis vulgaris. J Am Acad Dermatol 68:270–277CrossRefPubMed
17.
Zurück zum Zitat Höger PH, Hamm H (2014) Psoriasis vulgaris bei Kindern und Jugendlichen. Pathogenese, Klinik und Therapie. Monatsschr Kinderheilk 162:163–177 Höger PH, Hamm H (2014) Psoriasis vulgaris bei Kindern und Jugendlichen. Pathogenese, Klinik und Therapie. Monatsschr Kinderheilk 162:163–177
18.
Zurück zum Zitat Huemer C (2013) Juvenile Psoriasisarthritis. In: Wagner N, Dannecker G (Hrsg) Pädiatrische Rheumatologie. 2 Aufl. Springer, Heidelberg, S 233–238 Huemer C (2013) Juvenile Psoriasisarthritis. In: Wagner N, Dannecker G (Hrsg) Pädiatrische Rheumatologie. 2 Aufl. Springer, Heidelberg, S 233–238
19.
Zurück zum Zitat de Jager ME, de Jong EM, van de Kerkhof PC, Seyger MM (2010) Efficacy and safety of treatments for childhood psoriasis: a systematic literature review. J Am Acad Dermatol 62:1013–1030CrossRefPubMed de Jager ME, de Jong EM, van de Kerkhof PC, Seyger MM (2010) Efficacy and safety of treatments for childhood psoriasis: a systematic literature review. J Am Acad Dermatol 62:1013–1030CrossRefPubMed
20.
Zurück zum Zitat de Jager ME, van de Kerkhof PC, de Jong EM, Seyger MM (2010) A cross-sectional study using the Children´s Dermatology Life Quality Index (CDLQI) in childhood psoriasis: negative effect on quality of life and moderate correlation of CDLQI with severity scores. Br J Dermatol 163:1099–1101CrossRefPubMed de Jager ME, van de Kerkhof PC, de Jong EM, Seyger MM (2010) A cross-sectional study using the Children´s Dermatology Life Quality Index (CDLQI) in childhood psoriasis: negative effect on quality of life and moderate correlation of CDLQI with severity scores. Br J Dermatol 163:1099–1101CrossRefPubMed
21.
Zurück zum Zitat de Jager ME, van de Kerkhof PC, de Jong EM, Seyger MM (2010) Dithranol therapy in childhood psoriasis: unjustifiably on the verge of falling into oblivion. Dermatology 220:329–332CrossRefPubMed de Jager ME, van de Kerkhof PC, de Jong EM, Seyger MM (2010) Dithranol therapy in childhood psoriasis: unjustifiably on the verge of falling into oblivion. Dermatology 220:329–332CrossRefPubMed
22.
Zurück zum Zitat Jain VK, Bansal A, Aggarwal K, Jain K (2008) Enhanced response of childhood psoriasis to narrow-band UV-B phototherapy with preirradiation use of mineral oil. Pediatr Dermatol 25:559–564CrossRefPubMed Jain VK, Bansal A, Aggarwal K, Jain K (2008) Enhanced response of childhood psoriasis to narrow-band UV-B phototherapy with preirradiation use of mineral oil. Pediatr Dermatol 25:559–564CrossRefPubMed
23.
Zurück zum Zitat Kimball AB, Wu EQ, Guérin A et al (2012) Risks of developing psychiatric disorders in pediatric patients with psoriasis. J Am Acad Dermatol 67:651–657.e1–2CrossRefPubMed Kimball AB, Wu EQ, Guérin A et al (2012) Risks of developing psychiatric disorders in pediatric patients with psoriasis. J Am Acad Dermatol 67:651–657.e1–2CrossRefPubMed
24.
Zurück zum Zitat Koebnick C, Black MH, Smith N et al (2011) The association of psoriasis and elevated blood lipids in overweight and obese children. J Pediatr 159:577–583CrossRefPubMedCentralPubMed Koebnick C, Black MH, Smith N et al (2011) The association of psoriasis and elevated blood lipids in overweight and obese children. J Pediatr 159:577–583CrossRefPubMedCentralPubMed
25.
Zurück zum Zitat Kumar B, Jain R, Sandhu K et al (2004) Epidemiology of childhood psoriasis: a study of 419 patients from northern India. Int J Dermatol 43:654–658CrossRefPubMed Kumar B, Jain R, Sandhu K et al (2004) Epidemiology of childhood psoriasis: a study of 419 patients from northern India. Int J Dermatol 43:654–658CrossRefPubMed
26.
Zurück zum Zitat Kurd SK, Gelfand JM (2009) The prevalence of previously diagnosed and undiagnosed psoriasis in US adults: results from NHANES 2003–2004. J Am Acad Dermatol 60:218–224CrossRefPubMed Kurd SK, Gelfand JM (2009) The prevalence of previously diagnosed and undiagnosed psoriasis in US adults: results from NHANES 2003–2004. J Am Acad Dermatol 60:218–224CrossRefPubMed
27.
Zurück zum Zitat Leitlinie Therapie der Psoriasis vulgaris. Update 2011. AWMF-Register Nr. 013/001 Leitlinie Therapie der Psoriasis vulgaris. Update 2011. AWMF-Register Nr. 013/001
28.
Zurück zum Zitat Li WQ, Han JL, Zhang MF, Qureshi AA (2013) Interactions between adiposity and genetic polymorphisms on the risk of psoriasis. Brit J Dermatol 168:639–642CrossRef Li WQ, Han JL, Zhang MF, Qureshi AA (2013) Interactions between adiposity and genetic polymorphisms on the risk of psoriasis. Brit J Dermatol 168:639–642CrossRef
29.
Zurück zum Zitat Luu M, Cordoro KM (2013) The evolving role of biologics in the treatment of pediatric psoriasis. Skin Therapy Lett 18:1–4PubMed Luu M, Cordoro KM (2013) The evolving role of biologics in the treatment of pediatric psoriasis. Skin Therapy Lett 18:1–4PubMed
30.
Zurück zum Zitat Mahé E, Beauchet A, Bodemer C et al (2014) Psoriasis and obesity in French children: a case-control, multicentre study. Br J Dermatol 2014 Oct 31. doi:10.1111/bjd.13507 Mahé E, Beauchet A, Bodemer C et al (2014) Psoriasis and obesity in French children: a case-control, multicentre study. Br J Dermatol 2014 Oct 31. doi:10.1111/bjd.13507
31.
Zurück zum Zitat Mälkönen T, Wikström A, Heiskanen K et al (2014) Skin reactions during anti-TNFα therapy for pediatric inflammatory bowel disease: a 2-year prospective study. Inflamm Bowel Dis 20:1309–1315CrossRefPubMed Mälkönen T, Wikström A, Heiskanen K et al (2014) Skin reactions during anti-TNFα therapy for pediatric inflammatory bowel disease: a 2-year prospective study. Inflamm Bowel Dis 20:1309–1315CrossRefPubMed
32.
Zurück zum Zitat Morris A, Rogers M, Fischer G, Williams K (2001) Childhood psoriasis: a clinical review of 1262 cases. Pediatr Dermatol 18:188–198CrossRefPubMed Morris A, Rogers M, Fischer G, Williams K (2001) Childhood psoriasis: a clinical review of 1262 cases. Pediatr Dermatol 18:188–198CrossRefPubMed
34.
Zurück zum Zitat Oostveen AM, de Jager ME, van de Kerkhof PC et al (2012) The influence of treatments in daily clinical practice on the Children’s Dermatology Life Quality Index in juvenile psoriasis: a longitudinal study from the Child-CAPTURE patient registry. Br J Dermatol 167:145–149CrossRefPubMed Oostveen AM, de Jager ME, van de Kerkhof PC et al (2012) The influence of treatments in daily clinical practice on the Children’s Dermatology Life Quality Index in juvenile psoriasis: a longitudinal study from the Child-CAPTURE patient registry. Br J Dermatol 167:145–149CrossRefPubMed
35.
Zurück zum Zitat Oostveen AM, de Jong EM, Donders AR et al (2014) Treatment of paediatric scalp psoriasis with calcipotriene/betamethasone dipropionate scalp formulation: effectiveness, safety and influence on children’s quality of life in daily practice. J Eur Acad Dermatol Venereol 2014 Oct 13. doi:10.1111/jdv.12789 Oostveen AM, de Jong EM, Donders AR et al (2014) Treatment of paediatric scalp psoriasis with calcipotriene/betamethasone dipropionate scalp formulation: effectiveness, safety and influence on children’s quality of life in daily practice. J Eur Acad Dermatol Venereol 2014 Oct 13. doi:10.1111/jdv.12789
36.
Zurück zum Zitat Özden MG, Tekin NS, Gürer MA et al (2011) Environmental risk factors in pediatric psoriasis: a multicenter case-control study. Pediatr Dermatol 28:306–312CrossRefPubMed Özden MG, Tekin NS, Gürer MA et al (2011) Environmental risk factors in pediatric psoriasis: a multicenter case-control study. Pediatr Dermatol 28:306–312CrossRefPubMed
37.
Zurück zum Zitat Paller AS, Siegfried EC, Langley RG et al (2008) Etanercept Pediatric Psoriasis Study Group. Etanercept treatment for children and adolescents with plaque psoriasis. N Engl J Med 358:241–251CrossRefPubMed Paller AS, Siegfried EC, Langley RG et al (2008) Etanercept Pediatric Psoriasis Study Group. Etanercept treatment for children and adolescents with plaque psoriasis. N Engl J Med 358:241–251CrossRefPubMed
38.
Zurück zum Zitat Paller AS, Siegfried EC, Eichenfield LF et al (2010) Long-term etanercept in pediatric patients with plaque psoriasis. J Am Acad Dermatol 63:762–768CrossRefPubMed Paller AS, Siegfried EC, Eichenfield LF et al (2010) Long-term etanercept in pediatric patients with plaque psoriasis. J Am Acad Dermatol 63:762–768CrossRefPubMed
39.
Zurück zum Zitat Paller AS, Mercy K, Kwasny MJ et al (2013) Association of pediatric psoriasis severity with excess and central adiposity. JAMA Dermatol 149:166–176CrossRefPubMedCentralPubMed Paller AS, Mercy K, Kwasny MJ et al (2013) Association of pediatric psoriasis severity with excess and central adiposity. JAMA Dermatol 149:166–176CrossRefPubMedCentralPubMed
40.
Zurück zum Zitat Parisi R, Symmons DPM, Griffiths CEM et al (2013) Global epidemiology of psoriasis: a systematic review of incidence and prevalence. J Invest Dermatol 133:377–385CrossRefPubMed Parisi R, Symmons DPM, Griffiths CEM et al (2013) Global epidemiology of psoriasis: a systematic review of incidence and prevalence. J Invest Dermatol 133:377–385CrossRefPubMed
41.
Zurück zum Zitat Rosińska D, Wolska H, Jablonska S, Konca I (1988) Etretinate in severe psoriasis of children. Pediatr Dermatol 5:266–272CrossRefPubMed Rosińska D, Wolska H, Jablonska S, Konca I (1988) Etretinate in severe psoriasis of children. Pediatr Dermatol 5:266–272CrossRefPubMed
42.
Zurück zum Zitat Sigurdardottir SL, Thorleifsdottir RH, Valdimarsson H, Johnston A (2013). The role of the palatine tonsils in the pathogenesis and treatment of psoriasis. Brit J Dermatol 168:237–242CrossRef Sigurdardottir SL, Thorleifsdottir RH, Valdimarsson H, Johnston A (2013). The role of the palatine tonsils in the pathogenesis and treatment of psoriasis. Brit J Dermatol 168:237–242CrossRef
43.
Zurück zum Zitat Soltani-Arabshahi R, Wong B, Feng BJ et al (2010) Obesity in early adulthood as a risk factor for psoriatic arthritis. Arch Dermatol 146: 721–726CrossRefPubMed Soltani-Arabshahi R, Wong B, Feng BJ et al (2010) Obesity in early adulthood as a risk factor for psoriatic arthritis. Arch Dermatol 146: 721–726CrossRefPubMed
44.
Zurück zum Zitat Steinz K, Gerdes S, Domm S, Mrowietz U (2014) Systemic treatment with fumaric acid esters in six paediatric patients with psoriasis in a psoriasis centre. Dermatology 229:199–204CrossRefPubMed Steinz K, Gerdes S, Domm S, Mrowietz U (2014) Systemic treatment with fumaric acid esters in six paediatric patients with psoriasis in a psoriasis centre. Dermatology 229:199–204CrossRefPubMed
45.
Zurück zum Zitat Sticherling M (2012) Kinder und Jugendliche mit Psoriasis. Welche Maßnahmen werden empfohlen? Hautarzt 63:192–201CrossRefPubMed Sticherling M (2012) Kinder und Jugendliche mit Psoriasis. Welche Maßnahmen werden empfohlen? Hautarzt 63:192–201CrossRefPubMed
46.
Zurück zum Zitat Sugiura K, Takemoto A, Yamaguchi M et al (2013) The majority of generalized pustular psoriasis without psoriasis vulgaris is caused by deficiency of interleukin-36 receptor antagonist. J Invest Dermatol 133:2514–2521CrossRefPubMed Sugiura K, Takemoto A, Yamaguchi M et al (2013) The majority of generalized pustular psoriasis without psoriasis vulgaris is caused by deficiency of interleukin-36 receptor antagonist. J Invest Dermatol 133:2514–2521CrossRefPubMed
47.
Zurück zum Zitat Thorleifsdottir RH, Sigurdardottir SL, Sigurgeirsson B et al (2012) Improvement of psoriasis after tonsillectomy is associated with a decrease in the frequency of circulating T cells that recognize streptococcal determinants and homologous skin determinants. J Immunol 188:5160–5165CrossRefPubMed Thorleifsdottir RH, Sigurdardottir SL, Sigurgeirsson B et al (2012) Improvement of psoriasis after tonsillectomy is associated with a decrease in the frequency of circulating T cells that recognize streptococcal determinants and homologous skin determinants. J Immunol 188:5160–5165CrossRefPubMed
48.
Zurück zum Zitat Tollefson MM, Crowson CS, McEwoy MT, Kremers HM (2010) Incidence of psoriasis in children: a population-based study. J Am Acad Dermatol 62:979–987CrossRefPubMed Tollefson MM, Crowson CS, McEwoy MT, Kremers HM (2010) Incidence of psoriasis in children: a population-based study. J Am Acad Dermatol 62:979–987CrossRefPubMed
49.
Zurück zum Zitat Torres T, Machado S, Mendonça D, Selores M (2014) Cardiovascular comorbidities in childhood psoriasis. Eur J Dermatol 24:229–235PubMed Torres T, Machado S, Mendonça D, Selores M (2014) Cardiovascular comorbidities in childhood psoriasis. Eur J Dermatol 24:229–235PubMed
50.
Zurück zum Zitat Xiao T, Li B, He CD, Chen HD (2007) Juvenile generalized pustular psoriasis. J Dermatol 34:573–576CrossRefPubMed Xiao T, Li B, He CD, Chen HD (2007) Juvenile generalized pustular psoriasis. J Dermatol 34:573–576CrossRefPubMed
51.
Zurück zum Zitat Zhu KJ, He SM, Zhang C et al (2012) Relationship of the body mass index and childhood psoriasis in a Chinese Han population: a hospital-based study. J Dermatol 39:181–183CrossRefPubMed Zhu KJ, He SM, Zhang C et al (2012) Relationship of the body mass index and childhood psoriasis in a Chinese Han population: a hospital-based study. J Dermatol 39:181–183CrossRefPubMed
Metadaten
Titel
Psoriasis vulgaris bei Kindern und Jugendlichen
Pathogenese, Klinik und Therapie
verfasst von
Prof. Dr. P.H. Höger
H. Hamm
Publikationsdatum
01.04.2015
Verlag
Springer Berlin Heidelberg
Erschienen in
Die Dermatologie / Ausgabe 4/2015
Print ISSN: 2731-7005
Elektronische ISSN: 2731-7013
DOI
https://doi.org/10.1007/s00105-015-3585-1

Weitere Artikel der Ausgabe 4/2015

Der Hautarzt 4/2015 Zur Ausgabe

CME Zertifizierte Fortbildung

Lebensqualität in der Dermatologie

Panorama Dermatologische Praxis

Panorama Dermatologische Praxis

Dermatologie in Kunst und Geschichte

Musikdermatologie

Leitlinien kompakt für die Dermatologie

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

Update Dermatologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.