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The Goeckerman Regimen for the Treatment of Moderate to Severe Psoriasis
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Clinical Decisions in Pediatric Psoriasis: A Practical Approach to Systemic Therapy

Jennifer Ornelas1, Kelly M Cordoro1

  • 1Department of Dermatology, University of California, San Francisco School of Medicine, 1701 Divisadero Street, San Francisco, CA 94143, USA.

Dermatologic Clinics
|April 3, 2022
PubMed

Insights

Choosing systemic treatments for pediatric psoriasis involves patient-specific factors. This review guides selecting conventional and biologic therapies for moderate to severe childhood psoriasis.

Area of Science:

  • Pediatric Dermatology
  • Systemic Immunology
  • Pharmacology

Background:

  • Pediatric psoriasis management requires careful consideration of disease type, severity, and individual patient factors.
  • Treatment decisions involve balancing efficacy, safety, and patient-specific characteristics.
  • Both conventional systemic agents and newer biologic therapies are available.

Purpose of the Study:

  • To provide data and principles for guiding systemic treatment selection in pediatric psoriasis.
  • To highlight different clinical scenarios and therapeutic approaches for moderate to severe cases.
  • To compare conventional and biologic systemic therapies for children.

Main Methods:

  • Review of existing data on systemic treatments for pediatric psoriasis.
  • Discussion of factors influencing treatment choice, including disease characteristics and drug properties.
  • Presentation of use case examples for various clinical scenarios.

Main Results:

  • Conventional systemic agents (acitretin, methotrexate, cyclosporine, phototherapy) offer established safety and efficacy with flexible dosing.
  • Biologic agents provide high efficacy and reassuring safety profiles with minimal lab monitoring but can be costly and injectable.
  • Treatment selection depends on a constellation of clinical features and drug-related factors.

Conclusions:

  • Systemic therapy selection for pediatric psoriasis is complex, requiring individualized assessment.
  • Both conventional and biologic treatments have distinct advantages and disadvantages.
  • This review offers a framework for optimizing treatment strategies in children with moderate to severe psoriasis.

Keywords:
BiologicsDMARDSPediatric psoriasisPsoriasisPsoriasis treatmentsSystemic treatments

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