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Pediatric Plaque Psoriasis Treatment and Considerations for Patients With Skin of Color


Saakshi Khattri, MD, and Mark Lebwohl, MD, provide insight on the significance of steroid-free treatment options for the management of pediatric patients with plaque psoriasis and address unique considerations and challenges treating patients with skin of color.

This is a video synopsis of a discussion involving Mark Lebwohl, MD, Dean for Clinical Therapeutics and Chairman Emeritus of the Department of Dermatology at the Icahn School of Medicine at Mount Sinai in Manhattan, New York, and Saakshi Khattri, MD, a board-certified dermatologist, rheumatologist, and internist at the same institution.

Dr. Khattri highlights the approval of roflumilast for pediatric use, extending down to six-year-olds, which has significantly impacted the treatment approach for younger patients with psoriasis. The once-daily application of roflumilast provides a non-steroidal option, alleviating concerns regarding long-term steroid use in children. Dr. Lebwohl shares his experience of using both roflumilast and tapinarof in children before being aware of their official approval, emphasizing their efficacy and minimal side effects, particularly relevant for pediatric patients.

The discussion shifts to the treatment of psoriasis in patients with skin of color. Dr. Khattri highlights the underrepresentation of such patients in clinical trials and applauds Janssen's dedicated study, the VISIBLE trial, which specifically targets individuals self-identifying as non-white. The study demonstrates the effectiveness of guselkumab in skin of color, providing valuable data to address patient concerns about treatment efficacy. Additionally, the challenges of diagnosing psoriasis in skin of color due to delayed recognition and differential diagnoses are discussed.

Dr. Khattri shares a case where rapid clearance of psoriasis-associated post-inflammatory hyperpigmentation was achieved with effective treatment, surprising both the patient and the physician. This highlights the importance of educating patients about potential consequences of psoriasis treatment and the significant impact of addressing post-inflammatory hyperpigmentation on patient satisfaction and outcomes.

Video synopsis is AI-generated and reviewed by Dermatology Times® editorial staff.

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