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Updated: Mar 14, 2026
The Goeckerman Regimen for the Treatment of Moderate to Severe Psoriasis
Published on: July 11, 2013
Treatment Options for Pediatric Psoriasis
Dora Madiraca1, Mirna Šitum, Ivana Prkačin
1Dora Madiraca, MD, Department of Dermatology and Venereology "Sestre milosrdnice" University Hospital Centre, Vinogradska cesta 29, 10 000 Zagreb, Croatia; dora.madiraca85@gmail.com.
Insights
Pediatric psoriasis, a chronic skin condition, impacts children's quality of life. Treatment varies by severity, with biologics reserved for severe cases unresponsive to other therapies due to limited long-term safety data.
Area of Science:
- Dermatology
- Pediatric Immunology
- Inflammatory Diseases
Background:
- Psoriasis affects 0.5% to 2% of children, presenting as a multifactorial inflammatory papulosquamous disease.
- Pediatric psoriasis significantly diminishes patients' quality of life, necessitating tailored treatment strategies.
- Current treatments include topical therapies for mild cases and systemic or biologic agents for moderate to severe conditions.
Purpose of the Study:
- To review the treatment approaches for pediatric psoriasis.
- To discuss the role of various therapeutic modalities, including biologics.
- To highlight the considerations for using biologic agents in children.
Main Methods:
- Review of existing literature on pediatric psoriasis management.
- Analysis of treatment efficacy and safety profiles for different therapeutic classes.
- Emphasis on the current understanding of biologic agent use in pediatric populations.
Main Results:
- Topical treatments are effective for mild pediatric psoriasis.
- Moderate to severe cases often require phototherapy, systemic immunomodulators, or biologic agents.
- Limited data exists on the long-term safety and efficacy of biologics in children.
Conclusions:
- Individualized treatment is crucial for pediatric psoriasis.
- Biologic agents are a viable option for moderate-to-severe cases refractory to other treatments.
- Biologics should be administered by experienced dermatologists, with careful consideration of limited pediatric safety data.
Abstract:
Psoriasis is a multifactorial inflammatory papulosquamous disease affecting 0.5% to 2% of the pediatric population. Pediatric psoriasis, presenting similar to adult psoriasis, significantly reduces patient quality of life, often requiring an individualized treatment approach for each patient. Combination and rotational therapy are helpful in reducing toxicity and maximizing efficacy. Patients with mild and limited disease severity respond well to topical treatment with steroids or vitamin D analogues, unlike moderate and severe psoriasis where sufficient remission is rarely achieved. Therefore phototherapy, systemic immunomodulators, or biologic agents are the next line of treatment to be considered. There is limited data available on the use and long-term safety of biologics in the pediatric population. Biologic agents must be administered by experienced dermatologists, only in patients with moderate-to-severe plaque psoriasis who are intolerant or refractory to other systemic conventional disease-modifying treatment or phototherapy, or if those treatments are contraindicated.
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