Treatment Options for Pediatric Psoriasis

Psoriasis is a multifactorial inflammatory papulosquamous disease affecting 0.5% to 2% of paediatric population. Paediatric psoriasis, presenting similarly to adult psoriasis, significantly reduces patients’ quality of life, often requiring individualized treatment approach for each patient. Combination and rotational therapy are helpful in reducing toxicity and maximizing efficacy. Patients with mild and limited disease respond well to topical treatment with steroids or vitamin D analogues, unlike moderate and severe psoriasis where sufficient remission is rarely achieved. Therefore phototherapy, systemic immunomodulators, or biologic agents are next line of treatment to be considered. There is a limited data available on the use and long-term safety of biologics in the paediatric population. Biologic agents must be administered by experienced dermatologists, only in patients with moderate-to-severe plaque psoriasis, intolerant or refractory to other systemic conventional disease-modifying treatment or phototherapy, or if those agents are contraindicated. Psoriasis is a multifactorial inflammatory papulosquamous disease affecting 0.5% to 2% of paediatric population. Paediatric psoriasis, presenting similarly to adult psoriasis, significantly reduces patients’ quality of life, often requiring individualized treatment approach for each patient. Combination and rotational therapy are helpful in reducing toxicity and maximizing efficacy. Patients with mild and limited disease respond well to topical treatment with steroids or vitamin D analogues, unlike moderate and severe psoriasis where sufficient remission is rarely achieved. Therefore phototherapy, systemic immunomodulators, or biologic agents are next line of treatment to be considered. There is a limited data available on the use and long-term safety of biologics in the paediatric population. Biologic agents must be administered by experienced dermatologists, only in patients with moderate-to-severe plaque psoriasis, intolerant or refractory to other systemic conventional disease-modifying treatment or phototherapy, or if those agents are contraindicated. </div

Vitiligo in Croatia: A Case Report

Vitiligo is an acquired, chronic, multifactorial disorder which involves complex interactions between genetic risk factors and environmental triggers. It is characterized by scattered circumscribed depigmented macules and patches anywhere on the skin that result from loss of functional melanocytes. According to our statistical data, 1.6% of the general population in Croatia suffers from vitiligo, but varies based on region. It affects all age groups equally, with female patients being more affected (53.95%) than male patients, and no difference in severity of vitiligo. We present a case of a sudden onset of vitiligo vulgaris from a female patient in her twenties, treated at the Department of Dermatology and Venereology. Her 12-year-old brother simultaneously developed acrofacial vitiligo, six months after their mother died in a car accident. She has been previously diagnosed with type I diabetes and autoimmune endocrinopathies. The depigmented patches covered approximately 60% of her body, with Koebner response on trauma. Although no characteristic UV fl uorescence was detected on the affected area, histopathological and immunohistochemical analyses revealed a complete loss of melanocytes, while Langerhans` and dermal dendritic cells replaced the DOPA-positive melanocytes. TSH levels were elevated, and the ultrasound showed thyroid enlargement, which substantiated for a hypothyroidism therapy. Treatment by systemic corticosteroids for a 6 month period was successful in stabilizing the disease