Review Reveals the Hidden Burden of Psoriasis on Children, Families

Despite increasing research on psoriasis overall, data specific to children remain scarce.1 In 2 systematic literature reviews, researchers identified heightened challenges of moderate to severe disease, underscoring the need for further research to guide management and resource allocation.

This systematic literature review is published in Dermatology and Therapy.

A new study highlights the epidemiological, humanistic, and economic impact of pediatric psoriasis, with findings showing greater challenges in moderate to severe cases. | Image Credit: Evgeniya Primavera - stock.adobe.com

“The economic and humanistic burden of moderate to severe pediatric psoriasis remains understudied in the evidence base retrieved on our search date, with limited data available on cost-effectiveness, utility values, HCRU [health care resource utilization], and long-term financial burden,” wrote the researchers of the study. “Although some studies quantified direct health care costs, none provided a full economic evaluation and none linked the clinical effectiveness of biologic or other systemic therapies with real‑world costs or HCRU.”

Psoriasis in children extends far beyond skin symptoms, carrying a heavy physical, emotional, and social burden.2 Severe disease is linked to higher rates of depression, anxiety, obesity, and metabolic syndrome, whereas families often face disrupted sleep and financial stress from treatment costs. Social determinants of health—such as limited access to care, low health literacy, and economic instability—further amplify disparities in outcomes.

Systematic literature reviews were conducted to evaluate the burden of pediatric psoriasis. The first review focused on epidemiology and overall disease burden across all severities, whereas the second targeted the humanistic and economic burden in moderate to severe cases.1 Searches were performed across multiple bibliographic databases and supplemented by manual reviews of reference lists and relevant sources.

Eligible studies included interventional trials and observational real-world data reporting on prevalence, comorbidities, quality of life (QOL), caregiver impact, or health care resource utilization (HCRU) in children with psoriasis.

Across 56 studies, the reviews confirmed that pediatric psoriasis is a multisystem disease with significant health and QOL impacts. Prevalence increased with age, and obesity and asthma emerged as common risk factors. Children with psoriasis frequently experienced comorbidities across multiple domains, including mental health (depression, anxiety), metabolic (obesity, diabetes, hyperlipidemia), musculoskeletal (psoriatic arthritis), and gastrointestinal (celiac disease, ulcerative colitis, Crohn’s disease).

Disease severity strongly correlated with greater burden, including higher rates of metabolic syndrome, poorer health-related QOL, and increased caregiver stress, such as emotional distress and disrupted sleep. Although real-world and interventional data underscored the wide-ranging effects of pediatric psoriasis, economic evidence was limited, with no comprehensive analyses of health care costs or cost-effectiveness identified.

However, the researchers acknowledged some limitations. Evidence on pediatric psoriasis was limited by heterogeneity in the study design, outcome measures, and reliance on diagnostic coding, which increased the risk of misclassification and limited comparability. Additionally, most studies were observational, introducing potential bias and confounding. Furthermore, data on the economic and humanistic burden of moderate to severe disease were particularly scarce, with few standardized assessments of health care costs, resource use, or long-term QOL.

Despite these limitations, the researchers believe the study underscores the substantial but underrecognized burden of pediatric psoriasis and highlights the urgent need for more comprehensive research to inform clinical management, health policy, and resource allocation.

“The findings from this review indicate that psoriasis affects both children and their families, with greater impact observed in moderate to severe cases,” wrote the researchers. Emerging therapies may help improve outcomes, offering the potential to improve QOL and overall well-being for affected children and their caregivers.”

References

1. Sanchez SZ, Tran T, Garcia A, et al. Systematic literature reviews on the disease burden of pediatric psoriasis. Dermatol Ther (Heidelb). Published September 12, 2025. doi:10.1007/s13555-025-01541-9

2. Steinzor P. SPD 2025: Research highlights, personalized treatment, and barriers to care. AJMC®. August 4, 2025. Accessed September 15, 2025. https://www.ajmc.com/view/spd-2025-research-highlights-personalized-treatment-and-barriers-to-care