CHILDHOOD PSORIASIS: DIAGNOSTIC APPROACH AND CHALLENGES IN EARLY IDENTIFICATION

Abstract

Psoriasis is a chronic, immune-mediated inflammatory disease affecting approximately 1% of the pediatric population, with its incidence on the rise. Early diagnosis is fundamental for the proper management of the skin disease and for screening for associated comorbidities, such as psoriatic arthritis and obesity. This narrative review, based on articles from the PubMed database from the last five years, addresses the diagnostic aspects and challenges in identifying childhood psoriasis. The diagnosis is primarily clinical, but pediatric manifestations differ from adult ones: plaque psoriasis (the most common form, 75%) presents with finer, smaller, and less scaly lesions, with greater facial and flexural involvement. Guttate psoriasis (15-30%), frequently post-streptococcal, is the second most prevalent form. The main diagnostic challenge lies in the clinical overlap with other common childhood dermatoses, such as atopic dermatitis and seborrheic dermatitis, which generates uncertainty in non-specialists and can delay management. Dermatoscopy emerges as an auxiliary tool, while biopsy is rarely necessary. It is concluded that early identification is vital, requiring greater training and interdisciplinary collaboration to optimize the prognosis and quality of life of the pediatric patient.