This protocol applies to psoriasis presenting at anatomically sensitive sites: the face, the genitalia, or the body folds (intertriginous skin). These locations present distinct treatment considerations given the nature of the skin in these regions.
Management follows an escalation pathway broadly aligned with general plaque psoriasis, drawing on phototherapy and systemic options as severity warrants.
DOI: 10.1016/j.jaad.2019.08.049
Tacrolimus 0.1% ointment is recommended for off-label use as monotherapy for pediatric psoriasis of the face and genital region.
The systematic review of pediatric psoriasis treatment by de Jager et al recommends TCIs as the preferred first-line therapy for psoriasis of the face, genitalia, and body folds and includes pimecrolimus, tacrolimus, and cyclosporine.
NB-UVB is recommended as a treatment option for moderate to severe pediatric plaque and guttate psoriasis.
Methotrexate is recommended as an effective systemic therapy for moderate to severe plaque psoriasis and other psoriasis subtypes in children.
Etanercept is recommended as an effective therapy for moderate to severe psoriasis in children 6 years of age and older.
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