Psoriasis rash
Any child with a chronic or recurrent rash that is unresponsive to prescribed treatment deserves a trip to a pediatric dermatologist. With psoriasis, most kids have seen several doctors, even dermatologists, before the diagnosis is confirmed. Psoriasis is often not even considered in children because the average age of onset is 28 years (Dermatology Clinics, 1998; 16:593-608). Also, at least five different patterns of the psoriasis rash exist, all of which look quite different, adding to the likelihood of a missed diagnosis.
The five recognized forms of psoriasis include:
Guttate, in which the skin looks as if a hot liquid has splattered on it.
Plaque, the most common, with raised red patches and silvery scales.
Inverse, in which the rash is mostly on flexion creases, such as the inside of the elbows.
Erythrodermic, with sheets of reddened, scalded-appearing skin.
Pustular, with multiple little pimples.
One or more of these forms can appear simultaneously in a person with psoriasis, and the disease can shift from one form to another.
Although psoriasis is a long-term, recurrent problem for most who have it, the extent of the problem varies from quite mild to quite debilitating. It might be only a mild scalp condition, easily controlled with the appropriate, over-the-counter shampoo. It might show up as temporomandibular joint disease (TMJ), geographic tongue, or pitted nails. Or, for 5% to 10%, it might include the swollen hands and feet of psoriatic arthritis.
People with psoriasis may suffer discomfort, including pain and itching, restricted motion in their joints, and emotional distress.
In its most typical form, psoriasis results in patches of thick, red skin covered with silvery scales. These patches, which are sometimes referred to as plaques, usually itch and may burn. The skin at the joints may crack. Psoriasis most often occurs on the elbows, knees, scalp, lower back, face, palms, and soles of the feet but it can affect any skin site. The disease may also affect the fingernails, the toenails, and the soft tissues inside the mouth and genitalia. About 15 percent of people with psoriasis have joint inflammation that produces arthritis symptoms. This condition is called psoriatic arthritis. (Source: excerpt from Questions and Answers About Psoriasis: NIAMS)
People with psoriasis may notice that there are times when their skin worsens, then improves. Conditions that may cause flareups include changes in climate, infections, stress, and dry skin. Also, certain medicines, most notably beta-blockers, which are used to treat high blood pressure, and lithium or drugs used to treat depression, may trigger an outbreak or worsen the disease. (Source: excerpt from Questions and Answers About Psoriasis: NIAMS)
When psoriasis develops, patches of skin thicken, redden, and become covered with silvery scales. These patches are sometimes referred to as plaques. They may itch or burn. The skin at joints may crack. Psoriasis most often occurs on the elbows, knees, scalp, lower back, face, palms, and soles of the feet. The disease also may affect the fingernails, toenails, and the soft tissues inside the mouth and genitalia. About 10 percent of people with psoriasis have joint inflammation that produces symptoms of arthritis. This condition is called psoriatic arthritis. (Source: excerpt from Psoriasis: NWHIC)