Successful treatment of severe psoriasis vulgaris in child with methotrexate injection

Abstract

Pediatric psoriasis could begin in childhood in almost one-third of the cases. There are currently no international standardized guidelines for medical treatment of pediatric psoriasis. Case: A 3-years-old girl with a 1-year history of psoriasis came to outpatient clinic. She already went to dermatologist but only reached mild improvement. The lesion became worse within 2 months. PASI score was 32. The patient was given methotrexate injection 0,5 mg/BW/week for about 3 months. PASI score was decrease and became 15 after 3 months of the therapy with no serious side effect. Discussion: The treatment approach is based primarily on guidelines for adult psoriasis, a few case series, expert opinions, or experience with systemic drugs acquired in other pediatric disorders. Systemic treatment was given to this patient because the child was categorized as severe psoriasis. Conclusion: Methotrexate treatment in this patient was showed a good progression with no serious side effect.