Lisa Swanson, MD: Pediatric Psoriasis, Impact and Treatment Strategies

November 12, 2020
Jonathan Alicea

A pediatric dermatologist discusses her experience managing and treating psoriasis in children.

In the latest episode of Derm Discussions, pediatric dermatologist Lisa Swanson, MD, FAAD, discussed various dermatological issues and conditions concerning children.

She spent a portion of the episode discussing the impact of psoriasis, a condition than can have associations with certain comorbidities—such obesity, Chron’s disease, hypertension, hyperlipidemia, diabetes—in addition to various mental health burdens.

According to Swanson, such a condition can also largely impact parents and guardians, thus increasing feelings of anxiety, depression, and worry.

However, she touted recent advancements that have been made just in the realm of pediatric psoriasis alone.

“I heard a pediatric dermatologist a few years ago say that the treatment of pediatric psoriasis is about 10 years behind the adults. That’s all changing,” she said. “It’s due to a lot of the recent approvals, which is just so exciting.” 

She mentioned a few indications and approvals—like ustekinumab (Stelara), ixekizumab (Taltz), etanercept (Enbrel)—that have become available for patients as young as 6 or even 4 years of age.

She explained in greater detail how she has applied these biologics in her clinical practice and discussed her approach in guiding parents to make the appropriate treatment choices.

“Up until Taltz’s approval, my favorite biologic to treat pediatric psoriasis was Stelara,” she noted. “I feel that its safety profile is just incredible, and its infrequent dosing—to me– makes it an ideal choice in kids.”

Swanson also touched on her positive experience with access to these medications, which can always pose a roadblock for patients in need of certain therapies. She believed that the impact of comorbidities—as well as the idea of psoriasis as a systemic disease—has been foundational in persuading insurance companies to cover them.

And finally, she talked about how comorbid psoriatic arthritis has not been a prevalent issue for her within this population of children. Nonetheless, she noted a few symptoms that dermatologists should be aware of when treating these patients.