Pediatric Psoriasis Associated With Increased Risk for Comorbidity Development

A young child scratching her irritated skin.
A young child scratching her irritated skin.
The results suggest that dermatologists and pediatricians should be more proactive in screening for comorbidities in this population.

Children with psoriasis face an increased risk for developing a number of comorbidities, with obesity further increasing this risk, according to results of a study published in JAMA Dermatology.

Megha M. Tollefson, MD, of Mayo Clinic in Rochester, Minnesota, and colleagues sought to determine whether psoriasis is an independent risk factor for the development of comorbidities in pediatric patients and to what extent the risk is attributable to obesity. In a retrospective cohort study using data from Optum Laboratories Data Warehouse, Tollefson and colleagues identified 29,957 children with psoriasis and 29,957 children without psoriasis, and then separated them into 4 groups: (1) obese patients with psoriasis; (2) nonobese patients with psoriasis; (3) obese patients without psoriasis; and (4) nonobese patients without psoriasis.

Analysis showed that children with psoriasis were at a significantly increased risk for developing comorbidities, including obesity, hyperlipidemia, hypertension, diabetes, metabolic syndrome, polycystic ovarian syndrome, nonalcoholic liver disease, and elevated liver function compared with children without psoriasis. Comorbidities with the highest hazard ratio (HR) were nonalcoholic liver disease (HR 1.64), diabetes (HR 1.63), and hypertension (HR 1.57).

Obesity also increased the risk for developing each of the comorbidities; however, independent of obesity status, the overall risk for comorbidity development was approximately 40% to 75% higher in children with psoriasis.

“Dermatologists and pediatricians have a low rate of screening for comorbidities in pediatric patients,” the investigators stated. “[T]he knowledge gained in this study underscores the importance of closing this practice gap.”

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Tollefson MM, Van Houten HK, Asante D, Yao X, Maradit Kremers H. Association of psoriasis with comorbidity development in children with psoriasis [published online January 10, 2018]. JAMA Dermatol. doi:10.1001/jamadermatol.2017.5417