Kids with psoriasis need regular comorbidity screening: experts

Last Updated: 2017-05-25

By Reuters Staff

NEW YORK (Reuters Health) - Children with psoriasis need special attention to comorbidity screening in an effort to optimize their future health, according to an expert consensus.

Adults with psoriasis face an increased risk of myocardial infarction, diabetes, hypertension, hyperlipidemia, obesity, depression and other conditions. A few studies have shown similar associations in children with psoriasis.

Dr. Lawrence F. Eichenfield from the University of California, San Diego, School of Medicine and colleagues in the Pediatric Dermatology Research Alliance and National Psoriasis Foundation established an initiative to assess the current literature and establish screening recommendations for children.

Lacking sufficient pediatric studies, the group settled on a number of recommendations based on consensus, usual practice, opinion, disease-oriented evidence and case series.

Most recommendations coincide with those endorsed by the American Academy of Pediatrics for the general pediatric patient. They include:

* Annual screening for overweight and obesity beginning at age 2 years

* Screening of overweight patients every three years for type 2 diabetes beginning at age 10 years

* Lipid screening between ages 9-11 years and between ages 17-21 years

* Annual screening for hypertension beginning at age 3 years

* Screening for nonalcoholic fatty liver disease for children with risk factors.

Because psoriasis is associated with psychiatric comorbidities in all age groups, the expert panel also recommends annual screening for depression and anxiety, as well as annual screening for substance abuse beginning at 11 years of age.

The complete list of recommendations, along with the measures suggested for screening, appears in a report online May 17 in JAMA Dermatology.

"These mainly consensus-based recommendations provide a starting point for screening that will be refined as more is learned," the authors conclude. "As studies further detail the comorbidity risks in children, there may be a need to further stratify screening (e.g., by age group, disease subtype, severity)."

�€œEducating patients and their families about associated conditions, improving their lifestyle choices early, and providing a supportive environment are key components to their overall health management,�€ they add. �€œCommunication and collaboration between dermatologists, primary care providers, and other pediatric specialists will be critical to accomplish the recommended screenings and to limit the sequelae of this disorder.�€

Dr. Eichenfield did not respond to a request for comments.

SOURCE: http://bit.ly/2r08YCm

JAMA Pediatr 2017.