1. 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 .

2. Disclosure of interests
Conflict of interests : none .

3. 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 .

4. 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 ) .

5. 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

6. 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

7. 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):
2. Leman J, Burden D: Psoriasis in children: a guide to its diagnosis and management. Paediatr Drugs 2001, 3(9):
3. CeovićR, Pasić A, Lipozencić J, Murat-Susić S, Skerlev M, Husar K, KostovićK: Treatment of childhood psoriasis .ActaDermatovenerol Croat 2006, 14(4):