Pediatric Psoriasis Review Highlights Diagnostic Challenges, Expanding Role of Biologics
Pediatric psoriasis can substantially affect quality of life and contribute to cumulative life course impairment, but evidence guiding its management remains limited compared with adult disease, according to a narrative review of recent immunogenetic and therapeutic advances.
Researchers reviewed studies published in English, Portuguese, and Spanish from 2009 through 2025, focusing on psoriasis, child health, therapeutics, comorbidities, and T-lymphocyte antigen differentiation. The review also examined management challenges, including clinical heterogeneity, complex differential diagnosis, and limited treatment options, particularly in Brazil.
Chronic plaque psoriasis was identified as the most common presentation in pediatric patients. Diagnosis can be challenging because the differential diagnosis encompasses several conditions, including atopic dermatitis and autoimmune diseases. Evidence surrounding psoriasis-associated comorbidities in children, particularly cardiovascular risk, also remains controversial.
Although severe pediatric psoriasis is less common, the authors noted that it can have a substantial effect on quality of life. Available conventional treatments include topical corticosteroids, phototherapy, acitretin, methotrexate, and cyclosporine.
Biologic therapies have expanded treatment options for pediatric patients and have demonstrated greater efficacy than conventional treatments along with favorable safety profiles. However, the scarcity of pediatric-specific psoriasis guidelines remains an important limitation.
“Despite advances in understanding adult psoriasis, evidence in pediatric populations remains limited, especially in Brazil,” the authors wrote.
The review emphasizes the need to strengthen the evidence base surrounding pediatric disease to support earlier diagnosis and more individualized treatment decisions. Improving access to newer therapies is another priority identified by the authors.
“Expanding knowledge in pediatric psoriasis is essential to improve diagnosis, optimize treatment strategies, and increase access to innovative therapies, thereby reducing inflammatory burden and cumulative life course impairment,” they concluded.
Reference
Martinelli Salathiel AS, Secamilli EN, Maciel MG, Serrano JYM, da Costa França AFE, Magalhães RF. Pediatric psoriasis: from immunogenetics to targeted therapies. An Bras Dermatol. 2026;101(4):501413. doi:10.1016/j.abd.2026.501413
