Psoriatic arthritis in children

Juvenile psoriatic arthritis has been accepted as a disease entity. Arthritis and psoriasis occur in the same individual more often than would be expected by pure coincidence and appear in about 2% to 4% of children with chronic arthritis. A genetic background becomes obvious with a family history of psoriasis in half of the patients, but no consistent HLA associations have been detected. A joint pattern with asymmetric arthritis of big and small joints and a high rate of dactylitis is typical for the disease. However, juvenile psoriatic arthritis presents in subsets that are similar to the subgroups of juvenile chronic arthritis but occurs with different frequencies. Oligoarticular courses dominate in psoriatic patients, and systemic manifestations are extremely rare. For children with symmetric polyarthritis who are at risk to develop severe disabling disease, early aggressive therapy should be considered.