Pediatric Psoriasis: From New Insights into Pathogenesis to Updates on Treatment

Biomedicines - Tập 9 Số 8 - Trang 940
Hye One Kim1,2, Seok Young Kang2, Jin Cheol Kim2, Chun Wook Park1,2, Bo Young Chung1,2
1Department of Dermatology, Hallym University College of Medicine, Chuncheon 24252, Korea
2Department of Dermatology, Hallym University Kangnam Sacred Heart Hospital, Seoul 07441, Korea

Tóm tắt

Psoriasis is a chronic inflammatory systemic disease primarily affecting the skin, but which often involves considerable comorbidities as well. One-third of psoriasis cases start during childhood. In pediatric psoriasis, an association with several medical comorbidities is also indicated. Furthermore, because of its chronic nature and frequent relapses, psoriatic patients tend to require long-term treatment and experience negative impacts on their quality of life. Considering the different clinical characteristics of pediatric psoriasis, it has recently been presented that the pathogenesis of pediatric psoriasis is distinct from adult psoriasis. Treatment for pediatric psoriasis usually involves the same methods as for adults. However, most treatments in pediatric psoriasis are used off-label and research in this regard is still lacking. Targeted therapies involving newly developed biologics are also increasingly being applied to psoriasis in children. This review summarizes the clinical characteristics of pediatric psoriasis and focuses mainly on the updated concepts of pathogenesis and treatments in pediatric psoriasis. This was undertaken to widen the understanding of these relevant aspects and to provide better management of pediatric psoriasis by clinicians.

Từ khóa


Tài liệu tham khảo

Bronckers, 2015, Psoriasis in Children and Adolescents: Diagnosis, Management and Comorbidities, Paediatr. Drugs, 17, 373, 10.1007/s40272-015-0137-1

Tollefson, 2010, Incidence of psoriasis in children: A population-based study, J. Am. Acad. Dermatol., 62, 979, 10.1016/j.jaad.2009.07.029

Parisi, 2013, Identification and Management of Psoriasis and Associated ComorbidiTy (IMPACT) project team. Global epidemiology of psoriasis: A systematic review of incidence and prevalence, J. Investig. Dermatol., 133, 377, 10.1038/jid.2012.339

Pietrzak, 2017, Psoriasis and metabolic syn-drome in children: Current data, Clin. Exp. Dermatol., 42, 131, 10.1111/ced.13014

Becker, 2014, Excess adiposity preceding pediatric psoriasis, JAMA Dermatol., 150, 573, 10.1001/jamadermatol.2014.324

Jensen, 2013, Effect of weight loss on the severity of psoriasis: A randomized clinical study, JAMA Dermatol., 149, 795, 10.1001/jamadermatol.2013.722

Liu, 2014, Psoriatic arthritis: Epidemiology, diagnosis, and treatment, World J. Orthop., 5, 537, 10.5312/wjo.v5.i4.537

Chiam, 2011, Juvenile psoriasis in European and Asian children: Similarities and differences, Br. J. Dermatol., 164, 1101, 10.1111/j.1365-2133.2010.10196.x

Griffiths, 2007, Pathogenesis and clinical features of psoriasis, Lancet, 370, 263, 10.1016/S0140-6736(07)61128-3

Farber, 1974, The natural history of psoriasis in 5600 patients, Dermatologica, 148, 1, 10.1159/000251595

Romiti, 2009, Psoriasis in childhood and adolescence, An. Bras. Dermatol., 84, 9, 10.1590/S0365-05962009000100002

Gudjonsson, 2003, Streptococcal throat in-fections and exacerbation of chronic plaque psoriasis: A prospective study, Br. J. Dermatol., 149, 530, 10.1046/j.1365-2133.2003.05552.x

Saul, 1998, Autoantibodies to autologous skin in guttate and plaque forms of psoriasis and cross-reaction of skin antigens with streptococcal antigens, Int. J. Dermatol., 37, 524, 10.1046/j.1365-4362.1998.00512.x

Silverberg, 2010, Update on pediatric psoriasis, part 1: Clinical features and demographics, Cutis, 86, 118

Silverberg, 2015, Update on pediatric psoriasis, Cutis, 95, 147

Thorleifsdottir, 2016, HLA-Cw6 homozygosity in plaque psoriasis is associated with streptococcal throat infections and pronounced improvement after tonsillectomy: A prospective case series, J. Am. Acad. Dermatol., 75, 889, 10.1016/j.jaad.2016.06.061

Ji, 2019, Koebner phenomenon leading to the formation of new psoriatic lesions: Evidences and mechanisms, Biosci. Rep., 39, BSR20193266, 10.1042/BSR20193266

Chiricozzi, A., Romanelli, P., Volpe, E., Borsellino, G., and Romanelli, M. (2018). Scanning the Immunopathogenesis of Psoriasis. Int. J. Mol. Sci., 19.

Albanesi, 2018, The Interplay Between Keratinocytes and Immune Cells in the Pathogenesis of Psoriasis, Front. Immunol., 9, 1549, 10.3389/fimmu.2018.01549

Ogawa, 2018, Pathogenesis of psoriasis and development of treatment, J. Dermatol., 45, 264, 10.1111/1346-8138.14139

Baliwag, 2015, Cytokines in psoriasis, Cytokine, 73, 342, 10.1016/j.cyto.2014.12.014

Nussbaum, 2021, Role of regulatory T cells in psoriasis pathogenesis and treatment, Br. J. Dermatol., 184, 14, 10.1111/bjd.19380

Tsoi, 2017, Large scale meta-analysis characterizes genetic architecture for common psoriasis associated variants, Nat. Commun., 8, 15382, 10.1038/ncomms15382

Liu, Y., Helms, C., Liao, W., Zaba, L.C., Duan, S., Gardner, J., Wise, C., Miner, A., Malloy, M.J., and Pullinger, C.R. (2008). A genome-wide association study of psoriasis and psoriatic arthritis identifies new disease loci. PLoS Genet., 4.

Andressen, 1982, Erblichkeit der Psoriasis. Eine Analyse von 2035 Familienanamnesen [Inheritance of pso-riasis. Analysis of 2035 family histories], Hautarzt, 33, 214

Kim, 2020, Comparison of Cytokine Expression in Paediatric and Adult Psoriatic Skin, Acta Derm. Venereol., 100, adv00058

Cordoro, 2017, Skin-infiltrating, interleukin-22-producing T cells differentiate pediatric psoriasis from adult psoriasis, J. Am. Acad. Dermatol., 77, 417, 10.1016/j.jaad.2017.05.017

Zhang, 2016, Characterization of Th17 and FoxP3(+) Treg Cells in Paediatric Psoriasis Patients, Scand. J. Immunol., 83, 174, 10.1111/sji.12404

Cline, 2020, Biologic Treatment Options for Pediatric Psoriasis and Atopic Dermatitis-A Review, J. Clin. Aesthet. Dermatol., 13, 33

Haulrig, 2021, Off-Label Treatments for Pediatric Psoriasis: Lessons for the Clinic, Psoriasis, 11, 1, 10.2147/PTT.S268462

Maul, 2021, Topical Treatment of Psoriasis Vulgaris: The Swiss Treatment Pathway, Dermatology, 237, 166, 10.1159/000512930

Lamba, 2001, Combination therapy with vitamin D analogues, Br. J. Dermatol., 144, 27, 10.1046/j.1365-2133.2001.144s58027.x

Jacobi, 2015, Keratolytics and emollients and their role in the therapy of psoriasis: A systematic review, Dermatol. Ther., 5, 1, 10.1007/s13555-015-0068-3

Thomas, 2016, Treating pediatric plaque psoriasis: Challenges and solutions, Pediatric Health Med. Ther., 7, 25, 10.2147/PHMT.S75834

Silverberg, 2010, Update on pediatric psoriasis, Part 2: Therapeutic management, Cutis, 86, 172

Fluhr, 2008, Emollients, moisturizers, and keratolytic agents in psoriasis, Clin. Dermatol., 26, 380, 10.1016/j.clindermatol.2008.01.015

Shah, 2013, Diagnosis and treatment of pediatric psoriasis: Current and future, Am. J. Clin. Dermatol., 14, 195, 10.1007/s40257-013-0026-8

Kimball, 2008, Clobetasol propionate emulsion formulation foam 0.05%: Review of phase II open-label and phase III randomized controlled trials in steroid-responsive dermatoses in adults and adolescents, J. Am. Acad. Dermatol., 59, 448, 10.1016/j.jaad.2008.04.020

Bhutani, 2012, Management of pediatric psoriasis, Pediatr. Ann., 41, e1, 10.3928/00904481-20111209-08

Seyger, 2010, Efficacy and safety of treatments for childhood psoriasis: A systematic literature review, J. Am. Acad. Dermatol., 62, 1013, 10.1016/j.jaad.2009.06.048

Herz, 1991, Halobetasol propionate cream by day and halobetasol propionate ointment at night for the treatment of pediatric patients with chronic, localized plaque psoriasis and atopic dermatitis, J. Am. Acad. Dermatol., 25, 1166, 10.1016/0190-9622(91)70319-W

Wang, 2014, Efficacy of topical calcineurin inhibitors in psoriasis, J. Cutan Med. Surg., 18, 8, 10.2310/7750.2013.13059

Steele, 2005, Topical tacrolimus in the treatment of inverse psoriasis in children, J. Am. Acad. Dermatol., 53, 713, 10.1016/j.jaad.2005.05.036

Brune, 2007, Tacrolimus ointment is effective for psoriasis on the face and intertriginous areas in pediatric patients, Pediatr. Dermatol., 24, 76, 10.1111/j.1525-1470.2007.00341.x

Carr, 2013, Topical calcineurin inhibitors for atopic dermatitis: Review and treatment recommendations, Paediatr. Drugs, 15, 303, 10.1007/s40272-013-0013-9

Malecic, 2016, Tacrolimus for the management of psoriasis: Clinical utility and place in therapy, Psoriasis, 6, 153, 10.2147/PTT.S101233

Mansouri, 2006, Pimecrolimus 1 percent cream in the treatment of psoriasis in a child, Dermatol. Online J., 12, 7, 10.5070/D37C3542MX

Oranje, 1997, Topical calcipotriol in childhood psoriasis, J. Am. Acad. Dermatol., 36, 203, 10.1016/S0190-9622(97)70281-0

Mul, 2014, Calcipotri-ol/betamethasone dipropionate ointment in mild-to-moderate paediatric psoriasis: Long-term daily clinical practice data in a prospective cohort, Br. J. Dermatol., 171, 363, 10.1111/bjd.12895

Gooderham, 2014, Safety and efficacy of calcipotriol plus betamethasone dipropionate gel in the treatment of scalp psoriasis in adolescents 12–17 years of age, Br. J. Dermatol., 171, 1470, 10.1111/bjd.13235

Menter, 2020, Joint American Academy of Dermatology-National Psoriasis Foundation guidelines of care for the management and treatment of psoriasis in pediatric patients, J. Am. Acad. Dermatol., 82, 161, 10.1016/j.jaad.2019.08.049

Seyger, 2020, Safety and efficacy of fixed-dose combination cal-cipotriol (50 μg/g) and betamethasone dipropionate (0.5 mg/g) cutaneous foam in adolescent patients (aged 12 to <17 years) with plaque psoriasis: Results of a phase II, open-label trial, J. Eur. Acad. Dermatol. Venereol., 34, 2026, 10.1111/jdv.16233

Diluvio, 2007, Childhood nail psoriasis: A useful treatment with tazarotene 0.05%, Pediatr. Dermatol., 24, 332, 10.1111/j.1525-1470.2007.00421.x

Seyger, 2010, Dithranol therapy in childhood psoriasis: Unjustifiably on the verge of falling into oblivion, Dermatology, 220, 329, 10.1159/000278241

Zvulunov, 1994, Efficacy of short-contact therapy with dithranol in childhood psoriasis, Int. J. Dermatol., 33, 808, 10.1111/j.1365-4362.1994.tb01005.x

Oostveen, 2014, The effectiveness and safety of short-contact dithranol therapy in paediatric psoriasis: A prospective comparison of regular day care and day care with telemedicine, Br. J. Dermatol., 170, 454, 10.1111/bjd.12621

Menter, 1984, Resistant childhood psoriasis: An analysis of patients seen in a day-care center, Pediatr. Dermatol., 2, 8, 10.1111/j.1525-1470.1984.tb00434.x

Kortuem, 2010, Results of Goeckerman treatment for psoriasis in children: A 21-year retrospective review, Pediatr. Dermatol., 27, 518, 10.1111/j.1525-1470.2010.01124.x

Borska, 2014, Oxidative damage to nucleic acids and benzo(a)pyrene-7,8-diol-9,10-epoxide-DNA adducts and chromosomal aberration in children with psoriasis repeatedly exposed to crude coal tar ointment and UV radiation, Longev. OMAC, 2014, 302528

Smith, 2017, Tapinarof Is a Natural AhR Agonist that Resolves Skin Inflammation in Mice and Humans, J. Investig. Dermatol. Symp. Proc., 137, 2110, 10.1016/j.jid.2017.05.004

Smith, 2020, Differential ligand binding distinguishes therapeutic from pathologic aryl hydrocarbon receptor (AhR) modulating agents: Implications for inflammatory skin disease, J. Investig. Dermatol., 140, S81, 10.1016/j.jid.2020.03.605

Bissonnette, 2012, Efficacy and safety of topical WBI-1001 in patients with mild to moderate psoriasis: Results from a randomized double-blind placebo-controlled, phase II trial, J. Eur. Acad. Dermatol. Venereol., 26, 1516, 10.1111/j.1468-3083.2011.04332.x

Paller, 2021, Efficacy and patient-reported outcomes from a phase 2b, randomized clinical trial of tapinarof cream for the treatment of adolescents and adults with atopic dermatitis, J. Am. Acad. Dermatol., 84, 632, 10.1016/j.jaad.2020.05.135

Walters, 1999, Suberythemogenic narrow-band UVB is markedly more effective than conventional UVB in treatment of psoriasis vulgaris, J. Am. Acad. Dermatol., 40, 893, 10.1016/S0190-9622(99)70076-9

Altaykan, 2008, Phototherapy in childhood, Pediatr. Dermatol., 25, 599, 10.1111/j.1525-1470.2008.00773.x

Jain, 2007, Narrow-band UV-B phototherapy in childhood psoriasis, Int. J. Dermatol., 46, 320, 10.1111/j.1365-4632.2007.03148.x

Bronckers, 2017, Safety of Systemic Agents for the Treatment of Pediatric Psoriasis, JAMA Dermatol., 153, 1147, 10.1001/jamadermatol.2017.3029

Ramnarine, 2013, Treatment of childhood psoriasis with phototherapy and photochemo-therapy, Clin. Med. Insights Pediatr., 7, 25

Kaur, 2008, Systemic methotrexate treatment in childhood psoriasis: Further experience in 24 children from India, Pediatr. Dermatol., 25, 184, 10.1111/j.1525-1470.2008.00629.x

Warren, 2008, Methotrexate for psoriasis in the era of biological therapy, Clin. Exp. Dermatol., 33, 551, 10.1111/j.1365-2230.2008.02976.x

Herfarth, 2016, Use of Methotrexate in the Treatment of Inflammatory Bowel Diseases, Inflamm. Bowel. Dis., 22, 224, 10.1097/MIB.0000000000000589

Ergun, 2017, Efficacy, safety and drug survival of conventional agents in pediatric psoriasis: A multicenter, cohort study, J. Dermatol., 44, 630, 10.1111/1346-8138.13713

Mul, 2015, Systemic treatments in paediatric psoriasis: A systematic evidence-based update, J. Eur. Acad. Dermatol. Venereol., 29, 425, 10.1111/jdv.12749

Rendon, A., and Schäkel, K. (2019). Psoriasis Pathogenesis and Treatment. Int. J. Mol. Sci., 20.

Celebi, 2001, Low dose cyclosporin A treatment in generalized pustular psoriasis, Pediatr. Dermatol., 18, 246, 10.1046/j.1525-1470.2001.018003246.x

(2015). Cyclosporine [Package Insert], Novartis Pharmaceutical Corporation.

Yazici, 2016, Clinical experience with systemic cyclosporine A treatment in severe childhood psoriasis, J. Dermatolog. Treat., 27, 328, 10.3109/09546634.2015.1115813

Dogra, 2017, Systemic cyclosporine treatment in severe childhood psoriasis: A retro-spective chart review, J. Dermatol. Treat., 28, 18, 10.3109/09546634.2015.1034072

Lebwohl, 2018, Psoriasis, Ann. Intern. Med., 168, ITC49, 10.7326/AITC201804030

Wolska, 1988, Etretinate in severe psoriasis of children, Pediatr. Dermatol., 5, 266, 10.1111/j.1525-1470.1988.tb00902.x

Napolitano, 2016, Systemic Treatment of Pediatric Psoriasis: A Review, J. Drugs Dermatol., 6, 125

Popadic, 2014, Pustular psoriasis in childhood and adolescence: A 20-year single-center experience, Pediatr. Dermatol., 31, 575, 10.1111/pde.12296

(2018). Absorica (Isotretinoin) [Package Insert], Galephar Pharmaceuticals Research, Inc.

Halverstam, 2006, Lack of significant skeletal changes after long-term, low-dose retinoid therapy: Case report and review of the literature, J. Cutan Med. Surg., 10, 291, 10.2310/7750.2006.00065

Marqueling, 2013, Systemic treatments for severe pediatric psoriasis: A practical approach, Dermatol. Clin., 31, 267, 10.1016/j.det.2012.12.005

Mrowietz, 2018, Clinical use of dimethyl fumarate in moderate-to-severe plaque-type psoriasis: A European expert consensus, J. Eur. Acad. Dermatol. Venereol., 32, 3, 10.1111/jdv.15218

Steinz, 2014, Systemic treatment with fumaric acid esters in six paediatric patients with psoriasis in a psoriasis centre, Dermatology, 229, 199, 10.1159/000363103

Paller, 2008, Etanercept treatment for children and adolescents with plaque psoriasis, N. Engl. J. Med., 358, 241, 10.1056/NEJMoa066886

Aslam, 2020, FDA Approved Biologics: Can Etanercept and Ustekinumab be Considered a First-Line Systemic Therapy for Pediatric/Adolescents in Moderate to Severe Psoriasis? A Systematic Review, Cureus, 12, e9812

Langley, 2011, Patient-reported outcomes in pediatric patients with psoriasis undergoing etanercept treatment: 12-week results from a phase III randomized controlled trial, J. Am. Acad. Dermatol., 64, 64, 10.1016/j.jaad.2010.02.060

Fabrizi, 2007, Etanercept in infants: Suberythrodermic, recalcitrant psoriasis in a 22 month-old child successfully treated with etanercept, Eur. J. Dermatol., 17, 245

Paller, 2010, Long-term etanercept in pediatric patients with plaque psoriasis, J. Am. Acad. Dermatol., 63, 762, 10.1016/j.jaad.2010.04.004

Paller, 2016, Long-term safety and efficacy of etanercept in children and adolescents with plaque psoriasis, J. Am. Acad. Dermatol., 74, 277, 10.1016/j.jaad.2015.09.056

Papp, 2017, Efficacy and safety of adalimumab every other week versus methotrexate once weekly in children and adolescents with severe chronic plaque psoriasis: A randomised, double-blind, phase 3 trial, Lancet, 390, 40, 10.1016/S0140-6736(17)31189-3

Xie, X., Wang, Y., Yao, S., Xia, Y., Luo, H., Li, L., and Lu, C. (2021). Biologics recommendations for patients with psoriasis: A critical appraisal of clinical practice guidelines for psoriasis. J. Dermatolog Treat., 1–36.

Saeki, 2020, Japanese guidance for use of biologics for pso-riasis (the 2019 version), J. Dermatol., 47, 201, 10.1111/1346-8138.15196

Landells, 2015, Ustekinumab in adolescent patients age 12 to 17 years with moderate-to-severe plaque psoriasis: Results of the randomized phase 3 CADMUS study, J. Am. Acad. Dermatol., 73, 594, 10.1016/j.jaad.2015.07.002

Klufas, 2016, Treatment of Moderate to Severe Pediatric Psoriasis: A Retrospective Case Series, Pediatr. Dermatol., 33, 142, 10.1111/pde.12782

Lim, H., Lee, S.H., Lee, H.T., Lee, J.U., Son, J.Y., Shin, W., and Heo, Y.-S. (2018). Structural Biology of the TNFα Antagonists Used in the Treatment of Rheumatoid Arthritis. Int. J. Mol. Sci., 19.

Pinson, 2016, Psoriasis in children, Psoriasis, 6, 121, 10.2147/PTT.S87650

Bodemer, 2021, Secukinumab demonstrates high effi-cacy and a favourable safety profile in paediatric patients with severe chronic plaque psoriasis: 52-week results from a Phase 3 double-blind randomized, controlled trial, J. Eur. Acad. Dermatol. Venereol., 35, 938, 10.1111/jdv.17002

Paller, 2020, Efficacy and safety of ixeki-zumab in a phase III, randomized, double-blind, placebo-controlled study in paediatric patients with moderate-to-severe plaque psoriasis (IXORA-PEDS), Br. J. Dermatol., 183, 231, 10.1111/bjd.19147

Blauvelt, 2017, Efficacy and safety of guselkumab, an anti-interleukin-23 monoclonal antibody, compared with adalimumab for the continuous treatment of patients with moderate to severe psoriasis: Results from the phase III, double-blinded, placebo- and active comparator-controlled VOYAGE 1 trial, J. Am. Acad. Dermatol., 76, 405, 10.1016/j.jaad.2016.11.041

Papp, 2017, Risankizumab versus Ustekinumab for Moderate-to-Severe Plaque Psoriasis, N. Engl. J. Med., 376, 1551, 10.1056/NEJMoa1607017

Papp, 2015, Tofacitinib, an oral Janus kinase inhibitor, for the treatment of chronic plaque psoriasis: Results from two randomized, placebo-controlled, phase III trials, Br. J. Dermatol., 173, 949, 10.1111/bjd.14018

Bachelez, 2015, Tofacitinib versus etanercept or placebo in moderate-to-severe chronic plaque psoriasis: A phase 3 randomised non-inferiority trial, Lancet, 386, 552, 10.1016/S0140-6736(14)62113-9

AlMutairi, 2020, Tofacitinib in Pediatric Psoriasis: An Open-Label Trial to Study Its Safety and Efficacy in Children, Dermatology, 236, 191, 10.1159/000503062