Important rash decisions
Health experts explain the symptoms, causes and treatment of psoriasis to
CHILDREN get rashes for all sorts of reasons but if the skin looks dry and scaly, it could be psoriasis? To mark Psoriasis Awareness Month in August, we asked experts to talk through what parents need to know about the condition...
What is psoriasis?
“An immune condition that affects the skin and sometimes the joints and nails,” says Skin + Me dermatologist Dr Malvina Cunningham.
Dr Laura Proudfoot, consultant dermatologist at The Portland Hospital (hcahealthcare.co.uk), explains: “The most common skin change is a red, raised patch of skin covered in silvery scale, called a ‘plaque.’ “In the most common presentation in both children and adults – chronic plaque psoriasis – these may be scattered on the arms, knees, body, hairline and scalp,” she adds. “Although plaques often appear a little less thick and scaly in children.”
How common is psoriasis?
“It’s thought to affect between 2% and 3% of people and can come on at any age,” says Dr Cunningham.
A chronic condition that can vary in severity throughout life, it tends to affect older children more, Dr Proudfoot explains: “Up to 40% of children with psoriasis will develop symptoms before the age of 16 years, with around 10% of children expected to get symptoms before age 10.”
What causes psoriasis?
While doctors understand a fair bit about the process by which psoriasis develops, the underlying cause of the condition isn’t entirely clear.
“Skin cells are generally replaced every few weeks. However, psoriasis accelerates this process,” says Dr Proudfoot. “This build-up of
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skin cells results in the dry, scaly plaques.”
Dr Ahmed El Muntasar, GP and aesthetician aka The Aesthetics Doctor (theaestheticsdoctor.com), says: “The exact cause isn’t perfectly understood but we know there is an immune component to it, and there is also family history associated.”
Other factors can also play a role, Dr Proudfoot adds: “Some people also describe specific triggers for flare-ups, such as stress, certain medications, injury to the skin or after an unrelated infection.”
How is psoriasis diagnosed?
“Diagnosis is usually visual, so you see where the plaques are,” says Dr El Muntasar. “Because treatment of each of these locations is different.” It’s important to seek medical advice from a GP, who may refer your child to a dermatologist. Dr Proudfoot adds. “But in some cases, a biopsy of skin will be taken and sent to a laboratory for a more detailed analysis.”
What other conditions could be mistaken for psoriasis?
With so many different common rashes, psoriasis can also easily be mistaken for another condition.
“Sometimes people can mix up psoriasis with eczema, lichen planus, lupus (specifically discoid lupus) and fungal infections, as they can sometimes present with certain discoloration to the skin,” says Dr El Muntasar.
Dr Proudfoot agrees: “Psoriasis may be mistaken for eczema. Psoriasis localised to the scalp may be confused with dandruff or seborrheic dermatitis.” That’s why it’s so important to see your GP.
“Topical treatment can be very effective in controlling psoriasis,” she says, adding:. “And in those with more severe disease, light therapy, oral mediations and injectable biologic therapies may be prescribed under specialist care.”
Self-care and learning to identify your individual triggers can also help people manage flare-ups and symptoms.