How to treat guttae psoriasis in kids?

Hi,

Welcome to icliniq.com.

I can understand your concern.

I am sorry to hear about your son’s situation. It must be very worrying for you. Based on your description, your son may have developed guttate psoriasis, a type of psoriasis that can occur after an infection, particularly strep throat. Although psoriasis does tend to run in families, someone can develop it even if there is no family history.

Guttate psoriasis often develops in children and young adults, and it’s frequently triggered by an upper respiratory infection, such as strep throat. The condition presents as small, drop-shaped red patches, which can be scaly and itchy. It often appears on the elbows, knees, trunk, or scalp. In your son’s case, since the patches appeared after his strep throat infection and seem to be scaly and red, this is a strong possibility. Psoriasis is not contagious. Your son’s skin lesions are not a result of something that could spread to others, so the concerns from his classmates are understandable but unfounded. Reassure his teachers and peers that psoriasis cannot be spread through physical contact, as it is an autoimmune condition, not an infectious disease.

Tests to confirm psoriasis:

Although a paediatrician’s diagnosis is often based on appearance and symptoms, there are some tests or steps you can take to confirm the diagnosis and rule out other conditions:

1. Physical examination: A dermatologist will conduct a thorough examination of your son's skin to assess the type of lesions. Guttate psoriasis has a distinctive appearance, but a dermatologist can confirm this.
2. Skin biopsy: In some cases, a skin biopsy (removing a small sample of skin tissue for examination under a microscope) may be performed to rule out other conditions and confirm psoriasis.
3. Strep throat test: Since his symptoms started after a strep throat infection, it’s useful to confirm if the infection is related to the psoriasis flare-up. A throat swab can test for strep bacteria, although this might not be necessary if the strep throat was already diagnosed and treated.
4. Blood tests: While psoriasis does not require blood tests for diagnosis, a blood test can help rule out other underlying conditions, such as an autoimmune disorder, and assess overall health.

Steroid creams are commonly used in treating psoriasis because they help reduce inflammation and control flare-ups. However, using steroids in children requires special consideration:

1. Safety of steroid creams: Topical steroids are generally safe for short-term use in children when prescribed and used correctly. However, the potency of the steroid matters and stronger steroids (like Clobetasol) are not recommended for children unless necessary.
2. Milder Options: For children, milder corticosteroids, such as Hydrocortisone or Triamcinolone, are typically preferred. These are effective in managing psoriasis without significant side effects.
3. Usage instructions: It is important to follow the doctor’s instructions carefully and avoid overuse of steroids, as long-term use can cause skin thinning or other side effects. The cream should be applied in a thin layer and only on the affected areas.
4. Alternative treatments: If you are concerned about using steroids, your doctor may suggest other options such as vitamin D analogues (e.g., Calcipotriene) or coal tar preparations, which can be effective for children and have fewer risks.

Other tips for managing psoriasis in children:

1. Moisturize regularly: Applying a thick, emollient-rich moisturizer (e.g., petroleum jelly or an ointment) after bathing can help reduce dryness, flakiness, and itching. This is particularly important for children with psoriasis, as dry skin can worsen symptoms.
2. Gentle bathing: Use lukewarm water, as hot water can dry out the skin and aggravate psoriasis. Avoid harsh soaps and consider using a gentle, fragrance-free body wash.
3. Avoid scratching: Scratching can cause skin damage, making the condition worse and leading to bleeding or potential infections. To help prevent scratching, consider keeping your son’s nails short and gently reminding him not to scratch.
4. Sun exposure: Moderate exposure to sunlight can help reduce the severity of psoriasis by slowing the turnover of skin cells. However, it is important not to overdo it or cause a sunburn. Always apply sunscreen when your child is outdoors.
5. Manage stress: Emotional stress can exacerbate psoriasis, so help your son manage stress through relaxation techniques, talking about his feelings, or engaging in activities he enjoys.

Since your son has become withdrawn and quiet, it is crucial to address his emotional well-being as well:

1. Support: Encourage him to talk about how he feels and reassure him that psoriasis is not his fault and that it is not contagious. Acknowledge his feelings and let him know it is alright to feel upset.
2. School: It may help to have a meeting with the school teachers or counsellor to explain the condition and ensure your son feels supported. If his classmates understand that psoriasis is not contagious, it may reduce any social stress he is experiencing.
3. Counselling: If his emotional well-being continues to be affected, consider talking to a child psychologist to help him process his feelings and boost his self-esteem.
4. Next steps: Consult with a dermatologist to confirm the diagnosis and discuss treatment options. A dermatologist can guide you on which medications and treatments are safest for your son’s age and condition. Consider a second opinion or seek a pediatric dermatology specialist if you are unsure about the treatment or diagnosis. Follow up regularly to monitor your son’s skin and emotional health, and adjust treatment as necessary.

By addressing both the physical symptoms and emotional concerns, you can help your son manage his psoriasis and improve his quality of life.

I hope this information will help you.

Thanks.