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While psoriasis will more often affect adults, children can also be afflicted by this skin condition. Psoriatic arthritis develops from severe or untreated cases of psoriasis, in which inflammation of the skin is transferred to the joints of the body. The continuous inflammation of the joints will cause degeneration, leading to chronic arthritis.
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Incidence of Psoriatic Arthritis in Children
Psoriatic arthritis occurs in 8 to 20 percent of all juvenile arthritis cases. Generally, girls between the ages of 9 and 10 years of age are more likely to develop psoriatic arthritis than are boys, yet the condition can affect both genders at an earlier age. Psoriasis of the skin is apparent before the onset of arthritic symptoms in less than half of cases involving children and will usually develop in only one joint generally in the fingers and toes.
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Psoriatic skin conditions that precede the onset of arthritis in children will present as red, scaly skin that may or may not be in the joint areas. Symptoms may be seen in the fingernails or toenails, in which they become pitted and at times yellowish in color. Arthritic symptoms will present as red and inflamed skin in the joint area, accompanied by stiffness, swelling and pain in the joint. Chronic psoriatic arthritis in children will begin to cause deformity of the joint.
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Diagnosis of Psoriatic Arthritis in Children
There is a difficulty in diagnosing psoriatic arthritis due to the similarity of its symptoms to other diseases, such as gout and rheumatoid arthritis. Additionally, this condition may develop several years before positive symptoms appear. A medical interview and examination will be necessary due to the hereditary implications. In general, a rheumatologist will be best qualified to diagnose suspected psoriatic arthritis in children. This will include blood and joint fluid tests to specify the condition and possible x-rays to look for bone changes.
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Treatment will most often address both the skin condition and the joint inflammation, using either non-steroidal or steroidal medication to relieve symptoms, depending on the extent and severity of the condition. Immunosuppressive medications may be prescribed when symptoms relief medication is not effective. Physical therapy may be prescribed as well to maintain and improve joint and muscle function. Separate medication that addresses the dermal condition may also be prescribed.
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Related Health Issues
Chronic psoriatic arthritis in children can lead to other serious conditions, especially when left untreated. Severe deformity and immobility can be a long-term symptom of this condition in later years. Psoriasis itself can lead to increased risks of heart attack and diabetes and is associated with hypertension, obesity, metabolic dysfunctions, liver disease and cancer. A correlation between multiple sclerosis and psoriasis has also been indicated.
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Morgan Stanley Children's Hospital Columbia University Medical Center from the article Psoriatic Arthritis last updated Nov. 30, 2008