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Published on: July 11, 2013
Psoriasis in childhood: effective strategies to improve treatment adherence
Kara N Shah1, Sandra Cortina2,3, Michelle M Ernst2
1Division of Pediatric Dermatology.
Insights
Psoriasis in children, though often mild, impacts quality of life. Adherence to topical treatments is crucial but poorly understood in pediatric psoriasis, necessitating tailored interventions.
Area of Science:
- Dermatology
- Pediatrics
- Chronic Disease Management
Background:
- Psoriasis is a common chronic inflammatory skin condition in children with no cure.
- While often mild, pediatric psoriasis significantly affects quality of life due to visible symptoms, stigma, and treatment needs.
- Treatment adherence, particularly to topical therapies, is a known issue in adult psoriasis, impacting management strategies.
Purpose of the Study:
- To highlight the impact of pediatric psoriasis on quality of life.
- To address the lack of data on treatment adherence in pediatric psoriasis.
- To suggest strategies for assessing and improving adherence in children with psoriasis.
Main Methods:
- Review of existing literature on psoriasis management and treatment adherence in pediatric populations.
- Analysis of factors contributing to nonadherence in adult psoriasis.
- Application of general adherence assessment strategies from other pediatric diseases.
- Consideration of interventions used for other chronic dermatologic conditions.
Main Results:
- No published data currently exists on treatment adherence specifically within the pediatric psoriasis population.
- Poor adherence is often inferred in pediatric psoriasis when patients do not respond to appropriate therapies.
- Factors contributing to nonadherence in adults include lack of education, usability issues, and side effect concerns.
Conclusions:
- Pediatric psoriasis management requires addressing adherence challenges, despite the absence of specific data.
- Strategies for assessing and improving adherence in pediatric psoriasis can be adapted from other pediatric and dermatologic conditions.
- Improving adherence is essential for effective management and better outcomes for children with psoriasis.
Abstract:
Psoriasis is a relatively common chronic inflammatory skin disease in children for which there is no cure. Most children have mild disease that can be managed with topical therapy as opposed to phototherapy or systemic therapy. Despite the mild presentation of psoriasis in most children, the disease can have a significant impact on quality of life due to the need for ongoing treatment, the frequently visible nature of the cutaneous manifestations, and the social stigma that is associated with psoriasis. Adherence to treatment, in particular topical therapy, is often poor in adults and compromises response to therapy and medical provider management strategies. Multiple factors that may contribute to nonadherence in adults with psoriasis have been identified, including lack of education on the disease and expectations for management, issues related to ease of use and acceptability of topical medications, and anxiety regarding possible medication side effects. There is currently no published data on adherence in the pediatric psoriasis population; however, poor adherence is often suspected when patients fail to respond to appropriate therapy. General strategies used to assess adherence in other pediatric disease populations can be applied to children with psoriasis, and interventions that reflect experience in other chronic dermatologic disorders such as atopic dermatitis may also be helpful for medical providers caring for children with psoriasis.
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