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Infantile psoriasis
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Infantile psoriasis

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Contributors: Craig N. Burkhart MD, Dean Morrell MD, Lowell A. Goldsmith MD, MPH
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Synopsis

Infantile psoriasis : Confluent configuration, Diaper area, Erythema, Face, Fine scaly plaque, Intertriginous distribution, Trunk, White scaly plaque, Arms, Legs
This summary discusses psoriasis in infants. Psoriasis in adults and children is addressed separately.

Psoriasis is a chronic inflammatory skin disease that is seen in less than 1% of infants by 1 year of age and 2% of infants by age 2. Infantile psoriasis resembles adult psoriasis with discrete oval, erythematous plaques with white scale often involving the trunk, extremities, and face. There is usually less white scale on the plaques of infants as compared to adults. Lesions may be pruritic. The disease process results in hyperproliferation of epidermal cells causing thickened, often scaly skin. Lesions usually develop slowly but may have a sudden onset. Psoriasis in infancy typically involves the diaper area and face. Nail findings of pitting, onycholysis, oil spots, and subungual hyperkeratosis are present in 10% of affected infants.

Codes

ICD10CM:
L40.0 – Psoriasis vulgaris

SNOMEDCT:
402330006 – Onset of psoriasis in infancy (<1 year)

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

Occasionally, it is impossible to distinguish between alternative diagnoses, and one must follow the patient clinically for more specific signs to develop.
  • Seborrheic dermatitis – Favors intertriginous areas and has a greasy rather than dry, flaky scale.
  • Atopic dermatitis – Usually spares the diaper area and more commonly affects the shins and forearms.
  • Cutaneous candidiasis – Responds to antifungal therapy, has satellite pustules, and pseudohyphae using potassium hydroxide (KOH) preparation.
  • Acrodermatitis enteropathica – Initially vesicular or bullous; periorificial and acral preference; often associated with diarrhea, alopecia, and failure to thrive.
  • Irritant diaper dermatitis – Spares skin folds and limited to diaper area.
  • Scabies

Best Tests

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Therapy

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References

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Last Updated:02/05/2018
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Infantile psoriasis
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A medical illustration showing key findings of Infantile psoriasis : Confluent configuration, Diaper area, Erythema, Face, Fine scaly plaque, Intertriginous distribution, Trunk, White scaly plaque, Arms, Legs
Clinical image of Infantile psoriasis - imageId=14990. Click to open in gallery. caption: 'Pustular psoriasis in an infant displaying a large crusted and scaly erythematous plaque on the leg and foot, with outlying tiny pustules on the foot.'
Pustular psoriasis in an infant displaying a large crusted and scaly erythematous plaque on the leg and foot, with outlying tiny pustules on the foot.

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