Psoriasis in children. Diagnostic and therapeutic recommendations of the Polish Dermatological Society. Part 1

Introduction
Psoriasis is a chronic inflammatory disease that affects approximately 1–3% of the general population. In children, it occurs less frequently, most often develops in adolescence. Due to the more and more common forms of moderate and severe psoriasis in the pediatric population, it is necessary to present its nature, clinical presentation and comorbidity, as well as to standardize the therapeutic procedure. In the last dozen or so years, tremendous progress has been made in the pathogenesis of psoriasis, which has resulted in introduction of new therapeutic aims and methods of treatment. A fuller understanding of the nature of the disease, its coexistence with other diseases and a negative impact on the quality of life require a multidisciplinary approach and implementation of appropriate treatment, depending on the severity of the disease.

Objective
The purpose of recommendations of the Polish Dermatological Society is to present the literature current data on the use of local and systemic treatment, including biological therapies in psoriasis in the pediatric population. Coexisting diseases are also presented, as well as the impact of the dermatosis on the quality of life of children.

Material and methods
Recommendations were developed by a group of experts of the Polish Dermatological Society, taking into account their clinical experience, as well as the latest reports in Polish and world literature. Principles of treating psoriasis, useful in everyday dermatological practice, are taken into account.

Results and conclusions
Recommendations discuss principles of local treatment, classic systemic treatment and biological therapies. Treatment of psoriasis in children and adolescents poses a challenge for a dermatologist. Drugs approved for the treatment of this severe disease in the pediatric population have been introduced recently. The therapeutic procedure must be individualized. Systemic treatment should be considered for all psoriasis affecting more than 10% of the body.