Guttate psoriasis, a chronic, inflammatory skin disorder usually starts suddenly in childhood or young adulthood, and is typically only seen in those under age 30. This type of psoriasis appears as small, round or oval scaly spots most often found on the trunk of the body, arms, and legs, according to the National Psoriasis Foundation. In psoriasis, the scaly appearance comes from the acceleration of skin growth. Quite often it develops after a respiratory infection, streptococcal throat infection, sunburn, stress, or injury to the skin.
Topical Treatments
Treating psoriasis can be looked at as a three tier process beginning with topical therapy. According to the National Psoriasis Foundation, topical corticosteroids are the most widely used treatments for most psoriasis patients. Corticosteroids fight against the inflammation associated with the disease. They also have a immunosuppressive and vasoconstrictive effect. The strengths vary widely from what can be purchased over-the-counter to superpotent prescription medications. Side effects of using potent steroids, which can include the thinning of the skin, should be discussed with a physician. Topical synthetic vitamin D cream is useful in treating guttate type psoriasis. According to Alan Menter, MD, patients treated with this medication had a marked improvement, or clearing, of their psoriasis. It is not uncommon to use more than one cream in the treatment therapy. A topical retinoid, which is a derivative of vitamin A, could be prescribed at the discretion of the physician. Coal tar is another topical consideration for limited area use. Coal tar, a product of coal, is found in shampoos used for the treatment of scalp psoriasis. The National Psoriasis Foundation also notes that salicylic acid is a good option for treating psoriasis in combination with other topical therapies.
Light Therapy
Ultraviolet B (UVB) therapy is used to treat children. UVB treatment penetrates the skin and significantly slows down the growth of the affected skin. PUVA light therapy combines a psoralen drug with UVA light. Psoralen makes the body very sensitive to the UVA rays. PUVA light therapy is a short-term therapy used to bring a very severe case of psoriasis under control, but is not used in children under age 12.
Exposure to some sunlight can control psoriasis; however, sunburns should be avoided and proper sunscreen protection used. It makes good sense to routinely inspect the skin when there is ongoing exposure to sunlight or light treatments.
Systemic Therapy
Few children with severe cases of psoriasis require the use of systemic therapy, which uses various medications that affect the whole body, and not just the skin, to manage their symptoms. Cyclosporine and methotrexate are systemic therapies, according to the authors of "Pediatric Primary Care." During psoriasis remissions and exacerbations, it is important to control and relieve the symptoms since there is not a cure at this time.
References
- National Psoriasis Foundation: Types of psoriasis
- "American Academy of Dermatology, Inc."; Guidelines of care for the management of psoriasis and psoriatic arthritis; Alan Mentor, Chair; February 2009
- National Psoriasis Foundation: Treating psoriasis in children
- "Pediatric Primary Care"; Catherine Burns; 2008
