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Patients with paediatric psoriasis should be routinely screened to identify risk factors for disease comorbidities, according to recent consensus guidelines.

A panel specialising in paediatric psoriasis and dermatology has developed the first guidelines for comorbidity screenings among patients with the disease.

The authors of the guidelines wrote that a key part of managing psoriatic patients’ overall health is educating patients and their families about associated conditions to improve their lifestyle choices.

The panel’s recommendations for each paediatric psoriasis comorbidity are:

Obesity | Doctors should screen for obesity every year using the body mass index percentile, starting at two years of age.

Type 2 diabetes | Patients should be screened every three years starting at 10 years of age or at the onset of puberty if overweight.

Dyslipidemia | Patients aged nine-11 and 17-21 should receive universal lipid screenings. Screenings are also recommended in patients with any additional cardiovascular risk factors.

Hypertension | Doctors should screen for hypertension every year starting at three years of age, using age, sex and height reference charts.

Non-alcoholic fatty liver disease | Children with obesity or who are overweight with additional risk factors should be screened with alanine aminotransferase measurements at nine to 11 years of age.

Arthritis | Patients with paediatric psoriasis should be screened for the development of arthritis.

Mood disorders and substance abuse | Patients should be screened every year for depression and anxiety regardless of age. From 11 years of age, patients should be screened every year for substance abuse.

The panel also noted that:

• Doctors should be aware of the possible co-existence of polycystic ovary syndrome and consider directed testing if symptoms are present.
• Screening for uveitis is only warranted for patients with psoriatic arthritis.
• Formal gastrointestinal evaluation should be considered among patients with decreased growth rate, unexplained weight loss, or symptoms consistent with irritable bowel syndrome.

Read more recent research on psoriasis.

Source:
Osier E. et al. Pediatric Psoriasis Comorbidity Screening Guidelines. JAMA Dermatol. 2017;153(7):698–704. doi:10.1001/jamadermatol.2017.0499

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