[Specific aspects of psoriasis in children]

In 15% of the cases psoriasis begins before the age of 10 years, but it is often overlooked since its typical and obviously diagnostic nummular lesions are not the most frequently found. Some clinical features are very specific of children, such as eruptive guttate psoriasis occurring soon after an upper airway infection, and, mainly, the pauci-symptomatic forms which are difficult to diagnose as they are often very mild and for a long time reduced to one single lesion. The so-called "napkin psoriasis" is the usual early expression of the disease in infants. The severe, pustular, often annular, erythrodermal congenital and arthropathic forms of psoriasis are rare in children. Treatment must be prescribed with particular caution it that age, but in the severe and/or expansive types retinoids and very short courses of PUVA therapy are required.