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Updated: Mar 25, 2026
The Goeckerman Regimen for the Treatment of Moderate to Severe Psoriasis
Published on: July 11, 2013
Treatment of Moderate to Severe Pediatric Psoriasis: A Retrospective Case Series
Daniel M Klufas1, Jenna M Wald1, Bruce E Strober1,2
1Department of Dermatology, University of Connecticut Health Center, Farmington, Connecticut.
Insights
Systemic therapies, including biologics, are generally well-tolerated and effective for treating moderate to severe pediatric psoriasis. This study offers initial guidance on their use in children, despite limitations in sample size.
Area of Science:
- Pediatric Dermatology
- Immunology
- Pharmacology
Background:
- Pediatric psoriasis affects 0.5-2.0% of children, with limited data on systemic treatment safety and efficacy.
- Current research lacks comprehensive information on managing moderate to severe cases in pediatric populations.
Purpose of the Study:
- To evaluate the treatment response and safety of systemic therapies for moderate to severe pediatric psoriasis.
- To assess adverse event occurrence and disease control in children receiving systemic treatments.
Main Methods:
- A retrospective case series analyzed 51 children with moderate to severe psoriasis.
- Treatments included systemic therapies, with outcomes assessed via adverse event reporting and a 5-point Physician Global Assessment scale.
Main Results:
- Eighty treatment data points were collected from 51 patients; 29 treatments reported adverse events, mostly minor.
- Fatigue was the most common side effect (7.5%). Biologic and immunomodulating therapies showed positive disease response and were well-tolerated.
- Data limitations due to small sample size prevent comprehensive safety profiling or efficacy comparisons.
Conclusions:
- Despite study limitations, findings support the use of systemic therapies for pediatric psoriasis.
- The study provides preliminary guidance for managing moderate to severe pediatric psoriasis where data is scarce.
Background:
Psoriasis has an estimated prevalence of 0.5% to 2.0% in children. There is a paucity of data regarding the management and safety of treatments currently available for children with moderate to severe psoriasis. The aim of this study was to evaluate the treatment response and safety of systemic therapies used to manage moderate to severe pediatric psoriasis in a single referral center. Despite a small sample size, it was hypothesized that multiple therapeutics used for adult psoriasis would have a similar side-effect profile and positive disease response when used in a pediatric population.
Methods:
A retrospective case series evaluated 51 children with moderate to severe psoriasis treated with systemic therapies for adverse event occurrence and for disease response using a 5-point Physician Global Assessment scale.
Results:
Fifty-one patients, some of whom used multiple treatment options, produced 80 treatment data points. Adverse events were reported in 29 of these 80 treatments, with most being minor, subjective side effects. Overall, the most commonly reported side effect was fatigue, which was reported in 7.5% of treatments. Because of the small sample size, the data collected are limited and may not represent a comprehensive safety profile, nor do they allow comparison of efficacy between therapies. This case series found that biologic and immunomodulating therapies provide well-tolerated treatments with positive disease response for moderate to severe pediatric psoriasis.
Conclusion:
Although sample size and study design limit the data from this study, the study provides some guidance where little exists and helps to support the use of these treatments in this setting.
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