A case of severe psoriasis in an 1 year old baby A case of severe psoriasis in an 1 year old baby . Infant psoriasis case report Ancuta N. Proca ¹, Ioana Florea ¹, Caius Solovan ¹´² 1. University Clinic of Dermato-Venereology, Emergency Hospital,Timisoara,Romania, 2. " Victor Babes " University of Medicine and Pharmacy , Timisoara, Romania .

Disclosure of interests Conflict of interests : none .

A case of severe psoriasis in an 1 year old baby A case of severe psoriasis in an 1 year old baby . Infant psoriasis case report Introduction: Psoriasis is a chronic imuno- inflamatory dermatose which most commonly appears between the ages of 15 and 35, although it can suddenly appear at any age. Psoriasis can affect up to 1% of children . We present the case of a male patient, K.M.A. aged 1 year and 5 months , hospitalized in Children's Emergency Hospital with erythematosquamous lesions first misdiagnosed by a pediatric dermatologist as erythema multiforme . The pediatrician asked for a second opinion, sending the baby to be consulted in our clinic .

Family history : 2 cases of psoriasis (3rd degree relatives ) . Personal pathological history: the mother claims that the first eruption occurred at 2 months of age as a diaper rash , scaly erythematous plaques on the face and scaly greasy patches on the scalp , after vaccination against hepatitis B virus . After the antituberculosis vaccine the lesions extended to the entire body surface as a gutate scaly eruption . Figure 1 . Scaly erythematous plaques on the face – 2 months old Other previous diagnoses : infantile seborrheic dermatitis ( Cradle Cap) , oral candidiasis , acute pharyngotonsillitis , bilateral acute otitis media , cow’s milk allergy, rickets , anemia . Figure 2 . Napkin psoriasis at 2 months treated as a commune diaper rash Family history : 2 cases of psoriasis (3rd degree relatives ) .

On general examination we observed : fever, cough, rhinorrhea, congestive pharynx, discrete flared ribs . On local examination we noticed well-demarcated erythematous patches with silvery scale and punctuate bleeding when peeled (Auspitz's sign) , localized on face , upper and lower limbs , trunk , inguino – scrotal and gluteal area , translucent yellow-red discoloration of the nails with horizontal ridging . Figure 3 . Erythematous plaques on the face – 1 year and 5 months old Figure 4 . Hallux nail dystrophy

Results Our pacient received treatment from the pediatrician for the assessment of respiratory disease, anemia and deficiency rickets. For psoriasis we recommended topical corticosteroids, antihistamines and vitamin A oral drops . The patient remains in our observation , with favorable evolution at this moment . Figure 5 . Images showing our patient after the treatment - 1 year and 6 months old

Conclusion Psoriasis occurs rarely in babies . Certain genes have been identified as being linked to psoriasis, but just having an associated gene does not mean a child will develop psoriasis. In our case , triggers can include vaccination ,upper respiratory tract infections or tooth eruption . Treatment for infant psoriasis is limited due to the risks that psoriasis medications may pose to a developing baby. References : 1. Farber EM, Nall L: Childhood psoriasis.Cutis1999, 64(5):309-314. 2. Leman J, Burden D: Psoriasis in children: a guide to its diagnosis and management. Paediatr Drugs 2001, 3(9):673-680. 3. CeovićR, Pasić A, Lipozencić J, Murat-Susić S, Skerlev M, Husar K, KostovićK: Treatment of childhood psoriasis .ActaDermatovenerol Croat 2006, 14(4):261-264.