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The Goeckerman Regimen for the Treatment of Moderate to Severe Psoriasis
Published on: July 11, 2013
Management of pediatric psoriasis with acitretin: A review
Smriti Subedi1, Qian Yu1, Zeyu Chen1
1Department of Dermatology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, 200072, China.
Insights
Pediatric psoriasis, a chronic skin condition, impacts children's well-being. Acitretin offers a second-line treatment option for severe cases unresponsive to initial therapies, requiring careful monitoring.
Area of Science:
- Dermatology
- Pediatrics
- Pharmacology
Background:
- Psoriasis is a chronic inflammatory skin disease affecting all age groups.
- Pediatric psoriasis, while not uncommon, significantly impacts a child's physical and psychosocial health.
- Treatment options include topical therapies, phototherapy, and systemic agents, with limited controlled trials for children.
Purpose of the Study:
- To review the use of acitretin as a systemic therapy for pediatric psoriasis.
- To discuss the efficacy and safety considerations of acitretin in children.
- To highlight acitretin as a second-line treatment option for recalcitrant pediatric psoriasis.
Main Methods:
- Review of existing literature, case series, and expert opinions on pediatric psoriasis treatment.
- Analysis of data regarding the use of retinoids, specifically acitretin, in pediatric patients.
- Emphasis on the importance of low-dose acitretin with vigilant monitoring for adverse events.
Main Results:
- Systemic therapies for pediatric psoriasis often rely on non-controlled data and expert experience.
- Retinoids, including acitretin, are considered second-line treatments for pediatric psoriasis.
- Careful dosing and monitoring are crucial to mitigate potential serious adverse events associated with acitretin.
Conclusions:
- Acitretin can be a valuable second-line treatment for pediatric psoriasis unresponsive to topical therapies and phototherapy.
- Management requires a thorough understanding of its use, supported by clinical experience due to limited controlled trials.
- Close medical supervision, including physical examinations and laboratory investigations, is essential for safe acitretin use in children.
Abstract:
Psoriasis is a chronic inflammatory disease of the skin which can occur at any age-group. Psoriasis in childhood is not uncommon and has genetic susceptibility but usually, an environmental trigger such as infection is thought to initiate the disease process. Pediatric psoriasis has profound effects on both physical and psychosocial health of the patient. Treatment of mild psoriasis can be done with topical therapies but those which do not respond to topical therapies can be treated with phototherapy and systemic therapies. The use of systemic therapies in childhood is mainly based on the published data, case series, expert opinion and the experience as there is the lack of controlled trials in the age group. Based on the experience retinoids are probably the second line drugs for the treatment of pediatric psoriasis which do not respond to topical therapies and phototherapy. Using acitretin in a low dose and with proper physical examinations and laboratory investigations will reduce the hazard of potential serious adverse events. This article gives the review of the use of acitretin in pediatric psoriasis.
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