Psoriasis is an enduring immune-mediated provocative skin disease affecting the skin and joints. The World Health Organization (WHO) has recognized psoriasis as a chronic noncommunicable disease and an area of unmet health need. Ensuring quick diagnosis and recognizing other priority areas for research are highlighted by both the Psoriasis Priority Setting Partnership and the WHO.Psoriasis can be challenging to diagnosein children. 

A recent study delivers history- and examination-based data on the clinical features of psoriasis in children and recommends seven diagnostic standards with good discriminatory skill in secondary-care patients. The 7 criteria are: i) scale and erythema in the scalp involving the hairline; ii) scaly erythema inside the external auditory meatus; iii) persistent well-demarcated erythematous rash anywhere on the body; iv) scaly erythematous plaques on the extensor surfaces of the elbows and/or knees; v) persistent erythema in the umbilicus; vi) well-demarcated erythematous rash in the napkin area involving the crural folds; vii) family history of psoriasis.

Three of the best prognostic criteria include skin in unseen sites, such as umbilicus, groin flexures and external hearing meatus. These criteria will therefore be accommodating to quick examination of these precise areas to control whether a patient has psoriasis or not. The DIPSOC study (a UK multicentre case-control diagnostic accuracy study) was planned as a development study and is a hopeful first step. Further studies are planned to explore and validate the diagnostic performance of individual criteria and the collective seven best predictive criteria in different datasets and settings.

Source: Chalmers RJG. Recognizing psoriasis in children and adolescents: the DIPSOC study. Br J Dermatol. 2022;186(2):213-4.