How Are Children and Teens Affected by Psoriatic Arthritis?
When psoriatic arthritis (PsA) begins in children under the age of 16, it is called juvenile arthritis. Juvenile arthritis is an umbrella term that encompasses many autoimmune and inflammatory conditions, including psoriatic arthritis, lupus, scleroderma, fibromyalgia, and others.1
The most common age of onset for psoriatic arthritis in children is between 9 and 11. Children are more likely to experience the onset of psoriatic arthritis and psoriasis simultaneously. However, up to 50% of children with psoriatic arthritis have the arthritis condition before the onset of psoriasis.2,3
Symptoms of juvenile psoriatic arthritis
The symptoms of psoriatic arthritis in children and teens are similar to those seen in adults:
- Joint pain – Kids often complain of pain in their joints or muscles after strenuous activity, but in children with psoriatic arthritis, the pain may be more noticeable first thing in the morning or after a nap, and lessening with movement throughout the day.
- Stiffness - Psoriatic arthritis can cause stiffness in the joints, again frequently occurring in the morning. Children with psoriatic arthritis may hold their arm or leg in a stiff position or walk with a limp. The stiffness is generally worse just after waking up.
- Swelling – Psoriatic arthritis in children can cause swelling or redness on the skin around painful joints. In addition, joints may feel warm to the touch.
- Skin Rash or Lesions – Flaky, red rash or lesions may appear before or after joint problems in children with psoriatic arthritis.1
Triggers for juvenile psoriatic arthritis
The exact cause of psoriatic arthritis is unknown, although it has a genetic component, often occurring in families. Studies have shown that the immune system in people with the genetic predisposition for psoriatic arthritis gets triggered. In children, the onset of psoriatic arthritis and psoriasis often follows an infection, such as strep throat, bronchitis, tonsillitis, a respiratory infection, or an earache.2
How juvenile psoriatic arthritis is diagnosed
Early diagnosis and treatment are critical in psoriatic arthritis to prevent or delay the potential joint damage that can cause deformity and disfigurement. There is no single blood test to diagnosis psoriatic arthritis in children, and diagnosis often involves a physical exam and may include x-rays or MRIs of the joints.2
Treating juvenile psoriatic arthritis
While there is no cure for juvenile psoriatic arthritis, treatment can provide periods of remission, times when no symptoms are evident. The goal of treatment is to reduce inflammation, control pain and improve the child’s quality of life. Treatment often involves a combination of medication, physical activity, and a healthy diet.1
Several of the treatment options that are used in adults with psoriatic arthritis are also approved by the U.S. Food and Drug Administration (FDA) for use in juveniles with PsA, including non-steroidal anti-inflammatory drugs (NSAIDs), corticosteroid injections, methotrexate, and several biologic treatments, such as Enbrel (etanercept), Humira (adalimumab), and infliximab,. One of the significant side effects of the biologic treatments in both adults and juveniles is the risk of serious infections, including tuberculosis (TB).4-6
Juvenile psoriatic arthritis self-care
Children with juvenile psoriatic arthritis need to learn the importance of following their treatment plan and managing their condition. Self-care for kids and teens with psoriatic arthritis involves dealing with the emotional and psychosocial aspects of the disease.1