Affiliation:
1. University of California at Davis School of Medicine, Department of Dermatology, Sacramento, California
Abstract
Objective To systematically summarize the literature examining comorbidities associated with juvenile psoriasis. Data Sources Ovid MEDLINE articles published between January 1, 1946, and January 21, 2012, and a manual search. Results were limited to English publications and human, “all child” patients, ages 0 to 18 years. Study Selection All investigations that examined the presence or prevalence of comorbidities associated with juvenile psoriasis were included. Data Extraction Study design, patient characteristics, psoriasis comorbidities, relevant outcomes, and measures of association were extracted. Data Synthesis The search resulted in 20 articles. Obesity, hyperlipidemia, hypertension, diabetes, depression, and Crohn's disease occur more frequently in patients with juvenile psoriasis than in their disease-free counterparts. Although the overall rate of comorbidities among patients with juvenile psoriasis appears twice that of children without psoriasis, this rate does not include psychiatric diseases. Conclusion The literature exploring relationships between juvenile psoriasis and comorbid conditions is sparse, and the evidence for these associations is lacking. The strongest evidence supports an association between obesity and juvenile psoriasis. Support for many other comorbidities was predominantly anecdotal. Additional research assessing physical and psychiatric comorbid conditions among the juvenile psoriasis population is required if clinicians are to make recommendations regarding prevention and management of comorbidities associated with juvenile psoriasis.