Video: Knock on Wood| Webinar: ACR/CHEST ILD Guidelines in Practice
fa-facebookfa-linkedinfa-youtube-playfa-rss

An official publication of the ACR and the ARP serving rheumatologists and rheumatology professionals

  • Conditions
    • Axial Spondyloarthritis
    • Gout and Crystalline Arthritis
    • Myositis
    • Osteoarthritis and Bone Disorders
    • Pain Syndromes
    • Pediatric Conditions
    • Psoriatic Arthritis
    • Rheumatoid Arthritis
    • Sjögren’s Disease
    • Systemic Lupus Erythematosus
    • Systemic Sclerosis
    • Vasculitis
    • Other Rheumatic Conditions
  • FocusRheum
    • ANCA-Associated Vasculitis
    • Axial Spondyloarthritis
    • Gout
    • Lupus Nephritis
    • Psoriatic Arthritis
    • Rheumatoid Arthritis
    • Systemic Lupus Erythematosus
  • Guidance
    • Clinical Criteria/Guidelines
    • Ethics
    • Legal Updates
    • Legislation & Advocacy
    • Meeting Reports
      • ACR Convergence
      • Other ACR meetings
      • EULAR/Other
    • Research Rheum
  • Drug Updates
    • Analgesics
    • Biologics/DMARDs
  • Practice Support
    • Billing/Coding
    • EMRs
    • Facility
    • Insurance
    • QA/QI
    • Technology
    • Workforce
  • Opinion
    • Patient Perspective
    • Profiles
    • Rheuminations
      • Video
    • Speak Out Rheum
  • Career
    • ACR ExamRheum
    • Awards
    • Career Development
  • ACR
    • ACR Home
    • ACR Convergence
    • ACR Guidelines
    • Journals
      • ACR Open Rheumatology
      • Arthritis & Rheumatology
      • Arthritis Care & Research
    • From the College
    • Events/CME
    • President’s Perspective
  • Search

Molecular Differences Between Pediatric & Adult Psoriasis Plaques

Marilynn Larkin  |  July 10, 2017

NEW YORK (Reuters Health)—The pathology of pediatric psoriasis differs from that of adult psoriasis, a finding that has implications for treatment, researchers suggest.

“Pediatric psoriasis often differs from adult psoriasis in presentation, triggers, natural history, and response to therapy, suggesting potential differences in the pathophysiology of the disease processes,” Dr. Kelly Cordoro of the University of California, San Francisco (UCSF) and colleagues observe in the Journal of the American Academy of Dermatology, online June 14.1

ad goes here:advert-1
ADVERTISEMENT
SCROLL TO CONTINUE

However, most studies examining the immunology of psoriasis have focused on adult patients. For the new research, the team used flow cytometry to characterize the inflammatory cell profiles of psoriatic plaques from pediatric patients and adult psoriasis skin obtained from the UCSF General Dermatology clinics. They also studied normal skin obtained from pediatric patients undergoing plastic surgical reconstructive or excisional procedures at from which benign normal tissue margins were available and would have otherwise been discarded, and normal, healthy adult skin obtained from patients undergoing elective surgery.

Ten pediatric psoriasis patients (eight boys, mean age 12) were included in the study. Most had mild psoriasis at the time of biopsy, but moderate to severe disease was reported by all but three patients at some point during the disease course. Two had ongoing moderate and one had very severe disease at the time of enrollment.

ad goes here:advert-2
ADVERTISEMENT
SCROLL TO CONTINUE

Lesional tissue from the pediatric patients had significantly increased IL-22 and significantly less elevation of IL-17 derived from CD41 and CD81 cells compared with tissues from adult psoriasis patients and pediatric controls.

Also in contrast to lesions from adults, lesional skin in pediatric patients did not have increases in regulatory T cells.

Dr. Cordoro tells Reuters Health, “This pilot study supports the notion that ‘kids are not just little adults’ when it comes to the immunopathology of psoriasis at the tissue level.”

“The results provide evidence that IL-22, in addition to and to a greater extent than IL-17, may be a major player in the pathologic mechanism of psoriasis in children,” she says by email.

“The overarching goal of research like this is to start a new era in which physicians are no longer forced to adapt knowledge gained from adult studies to the management of pediatric patients,” she stresses. “Our findings get us a step closer to unraveling the immunologic signature of pediatric psoriasis, which may reveal therapeutic targets unique to children.”

Dr. Adnan Mir, a pediatric dermatologist at Children’s Health in Dallas, tells Reuters Health by email, “Psoriasis often behaves differently in children and adults, and little is known about why that is the case. For example, psoriasis in children is often triggered by Streptococcal infections, such as Strep throat.”

“Despite the differences, we often treat adult and pediatric psoriasis using similar strategies,” he says.

“Over the past two to three decades, advances in the understanding of what causes psoriasis has led to the development of more sophisticated, targeted therapies—but these have, for the most part, been focused on adult disease,” he observes.

“This is an important study that addresses differences in adult and pediatric psoriasis at a molecular level,” he says. “This improved understanding of the cellular and molecular pathways that are active in pediatric psoriasis will help us to tailor our treatments specifically to this population, and lead to the development of newer, safer therapies.”


Reference

  1. Cordoro KM, Hitraya-Low M, Taravati K, et al. Skin-infiltrating, interleukin-22-producing T cells differentiate pediatric psoriasis from adult psoriasis. J Am Acad Dermatol. 2017 Jun 14. pii: S0190-9622(17)31735-8. doi: 10.1016/j.jaad.2017.05.017. [Epub ahead of print]

Page: 1 2 | Multi-Page
Share: 

Filed under:ConditionsPediatric ConditionsSystemic Sclerosis Tagged with:ChildrenPediatricplaquePsoriasisskin

Related Articles

    Tips for Transitioning Patients from Pediatric to Adult Rheumatology Care

    October 14, 2021

    Monkey Business Imagesl / shutterstock.com Approximately 50% of young adult patients with childhood-onset rheumatic diseases become lost to follow-up within the first year of transferring to adult rheumatology care, mirroring the statistics of other subspecialties.1,2 One of the challenges cited most consistently by young adult patients and their families relates to differences between rheumatology care…

    A Team Approach Improves the Transition from Pediatric to Adult Care

    April 17, 2021

    Gorynvd / shutterstock.com Nearly all adolescents and young adults (AYAs) with chronic pediatric rheumatic disease require transfer of care to an adult rheumatologist, yet almost half are lost from care at the time of transfer.1-3 Although sometimes framed as a discrete event, transition refers to the longitudinal process, often spanning several years, in which AYAs…

    MicroOne / shutterstock.com

    Rheumatology Drugs at a Glance, Part 2: Psoriasis

    May 17, 2019

    Over the past few years, bio­similars and other new drugs have been introduced to treat rheumatic illnesses. Some of the conditions we treat have numerous drug option; others have few or only off-label options. This series, “Rheumatology Drugs at a Glance,” provides streamlined information on the administration of biologic, biosimilar and other medications used to…

    What Adult Rheumatologists Need to Know about Juvenile Arthritis

    May 1, 2013

    How to recognize distinctions between pediatric and adult arthritis

  • About Us
  • Meet the Editors
  • Issue Archives
  • Contribute
  • Advertise
  • Contact Us
fa-facebookfa-linkedinfa-youtube-playfa-rss
  • Copyright © 2025 by John Wiley & Sons, Inc. All rights reserved, including rights for text and data mining and training of artificial technologies or similar technologies. ISSN 1931-3268 (print). ISSN 1931-3209 (online).
  • DEI Statement
  • Privacy Policy
  • Terms of Use
  • Cookie Preferences