Psoriasis in children: symptoms and treatment
Infectious disease is not, though still seen and the viral theory of origin.
The causes of the disease
The normal maturation cycle of skin cells is 30 days. When psoriasis he is reduced to 4-5 days, and this results in plaque formation. By electron microscopy established that in a healthy child's skin contains the same changes as in the affected areas. In addition, patients with psoriasis revealed a disruption of the nervous, endocrine, immune systems, metabolism and other changes in the body. This suggests that psoriasis is a systemic disease.
We can distinguish three main groups of causes of psoriasis:
Heredity is the leading factor in the development of psoriasis. This is confirmed by the study of a dermatosis that occur from the twins with relatives for several generations, as well as biochemical studies healthy family members. If sick one of the parents, the likelihood that a child will develop psoriasis is 25% if both sick – that 60-75%. With this type of inheritance remains unclear .
The environmental factors include seasonal changes, the contact of clothing with the skin, impact on the psyche of the child stress, relationship with peers. The focus of the children in the team on the ill child, the attitude to the "white crow", limiting contact for fear of becoming infected – all of these factors can provoke a new aggravation, an increase in the area affected of the skin. Especially vulnerable the psyche of a child in puberty, due to hormonal changes. Therefore, a large percentage of the disease has on teenagers.
The ratio of genetic and environmental factors that trigger the occurrence of psoriasis is 65% and 35%.
Infection start first, the allergic response mechanisms that can trigger the development of psoriasis. So, the disease can occur after influenza, pneumonia, pyelonephritis, hepatitis. Allocate even after the infectious form of the disease. It is characterized by abundant rash in the form of drops all over the body.
In some cases the appearance of psoriasis is preceded by trauma to the skin.
Psoriasis is characterized by the appearance of the skin rash in the form of Islands ("plaques") red with silvery-white areas, which are easily peeling and itching. The occurrence of cracks in the plaque may be accompanied by slight bleeding and a risk of joining a secondary infection.
Externally, skin rashes in children are similar to those in adults, but there are some differences. For children suffering from psoriasis, a very characteristic syndrome Kebnera – the appearance of lesions in areas affected by the irritation or injury.
For kids psoriasis is long, with the exception of the teardrop informibus, more favorable form of the disease. There are three stages of disease:
Progressive stage characterized by the formation of small itchy papules surrounded by a red rim. Can increase and compacted lymph nodes, especially in severe forms of psoriasis. In stationary phase the growth of the rash stops, the center of the plaques is flattened, reduced flaking. In the stage of regression of the lesions resorption, leaving depigmentation bezel (bezel Voronova). Rashes leave behind stains.
Localization of lesions may be different. Most often affects skin of elbows, knees, buttocks, umbilicus, scalp. Every third child with psoriasis affected nails. Often plaques can be detected in the folds of the skin. Also affects the mucous membranes, especially the language, and rashes can change the location and shape ("geographic tongue"). The skin of the palms and plantar surface of the foot characterized by hyperkeratosis (thickening of the upper layer of the epidermis). The face is affected less often, a rash appears on the forehead and cheeks, may spread to the ears
The blood test detects the increase in the number of total protein and gamma globulin, decrease albumin globulin ratio, reveal violations of fat metabolism.
Forms of child psoriasis
- psoriasis babies;
- psoriatic arthritis.
The most common form is guttate psoriasis. Manifested in the form of red bumps on the body and limbs that may occur after minor injuries, as well as after infection (otitis media, rinofaringita, flu, etc.). In a smear from a throat cytological examination revealed streptococci. Teardrop form of psoriasis is often confused with allergic reactions.
Plaque psoriasis is characterized by red rash with clear boundaries and a thick layer of white flakes.
Pustular form of the disease is rare. The appearance of ulcers can be triggered by infection, vaccination, use of certain medicines, stress. Pustular psoriasis that occurs in infants, called neonatal.
In erythrodermic psoriasis the skin of the child looks entirely red; in some areas of the skin may be plaque. Often, cutaneous manifestations are accompanied by fever and pain in the joints.
Pustular and erythrodermic psoriasis can take a generalized form with severe. They require hospital treatment to avoid death.
Psoriasis infants is known as diaper psoriasis. It's hard to diagnose because skin lesions occur most often in the buttocks and can be mistaken for manifestations of dermatitis due to irritation of the skin with urine and feces.
Psoriatic arthritis affects about 10% of children suffering from psoriasis. Joints swelling, have pain in your toes, ankle, knee, carpi joints. Often joins conjunctivitis.
Usually for any form of the disease every three months change. In summer due to solar insolation, the symptoms often subside.
For the first time a sick child with psoriasis it is best to be hospitalized.
- Assigned desensitization means (5% solution of calcium gluconate or 10% solution of calcium chloride inside, 10% solution of calcium gluconate intramuscularly) and sedatives (tincture of motherwort, Valerian).
- In severe itching appropriate antihistamines .
- Shows vitamins group B intramuscularly in 10-20 injections: B6 (Pyridoxine), B12 (Cyanocobalamin), B2 (Riboflavin); inside: B15 (Panagamuwa acid), B9 (Folic acid), a (Retinol) and C (Ascorbic acid).
- To activate the body's defenses, use drugs, have pyrogenic (increasing temperature) properties. They normalize the permeability of blood vessels and reduce the cell division rate of the epidermis.
- Shown weekly blood transfusions, the introduction of plasma and albumin.
- The ineffectiveness of treatment, and in severe cases, the doctor may prescribe glucocorticoids of the course in 2-3 weeks, with gradual dose reduction and subsequent withdrawal of the drug. The dosage is selected individually. Cytostatics to children is not appointed due to their toxicity.
- To combat the plaques on the palms and soles use occlusive (airtight) dressings with ointment of salicylic. On the affected scalp cause teofillinom or papaverine ointment.
- In stationary and regressive stages psoriasis children appoint UFO, sedative baths, phyto therapy.
Subject psoriasis frequent colds, you need to sanitize sources of infection: to cure teeth cavities, carry out deworming. A desirable step in the treatment of psoriasis is a Spa treatment.
We must remember that psoriasis is a chronic disease characterized by periods of exacerbation and remission, and be prepared for a long and regular treatment.
Child needs to inculcate a healthy lifestyle, learning to cope with stress, calmly respond to attacks on their peers. Particularly difficult situation of children who have affected skin. All family members must support a sick child that will help him to avoid complexes and grow up socially adapted person.
To what doctor to address
Psoriasis in children cure the dermatologist. If affects not only the skin but also the joints, are shown consultation of a rheumatologist, with the development of conjunctivitis ophthalmologist. You want to sanitize the foci of chronic infection, visit the dentist, the ENT physician. If there are difficulties in the differential diagnosis of psoriasis and allergic diseases — please refer to the allergist. In the treatment of the patient help the dietician, physiotherapist, psychologist.