Melodie Young, ASN, RN: Updates on Therapies for Pediatric Patients with Psoriasis, PsA

In a presentation titled ‘Psoriasis and Psoriatic Arthritis Update 2024’ at the Maui Derm NP+PA Fall 2024 conference in Nashville, expert faculty highlighted updates in the psoriasis and psoriatic arthritis (PsA) space within the last year. Specifically, they delved into new drugs and therapies as well as a series of challenging case scenarios.

One presenter was Melodie Young, ASN, RN. She is a board-certified, adult and pediatric Nurse Practitioner and the former director of the Psoriasis Center at Baylor University Medical Center. Young is known for her work in psoriasis and phototherapy-related committees for the American Academy of Dermatology, in addition to her role as founding member of the International Psoriasis Council.

In this interview with the HCPLive editorial team, Young spoke about key insights featured in her portion of the presentation at the Maui Derm conference.

First, Young instructed clinicians, PAs, and NPs, to review guidelines in their thinking about pediatric psoriasis. She noted that a lot of psoriasis appears in toddlers and children after an infection.

“A lot of us don't have time to read every article that's out there, so I always feel that when it's my turn to do a presentation I should read as much as I can so I can be succinct and summarize that data, to help NPs and PAs practice evidence-based medicine,” Young explained. “And that includes a review of the pediatric psoriasis guidelines of care. It also included a review of all the medications that are currently FDA approved for treating treatment in the pediatric population.”

Young commented that those with psoriasis who are obese should be made to feel aware that the condition is not their fault. Another notable fact she highlighted was that there is a 47% greater likelihood of psychotropic drug use in the pediatric population if they have psoriasis.

Anxiety in the pediatric population was noted as not as high, though depression was higher. This population also has a high incidence of facial and genital activity, which Young noted makes it considerably difficult.

Young also noted that it is not uncommon to see skin disease alongside rheumatoid arthritis, psoriatic arthritis, ulcerative colitis, and uveitis in the pediatric population. She was asked to comment on recent guideline updates and recommendations for pediatric patients with psoriatic disease.

Young highlighted approved biologic options for pediatric patients with psoriasis (etanercept, ustekinumab, ixekixumab, secukinumab) as well as systemics such as apremilast. She also mentioned topicals such as corticosteroids, off-label calcipotreine, off-label topical calcineurin inhibitors (TCIs), and roflumilast.

Young noted that topical corticosteroids should not be used in chronic skin disease, and specifically among children. She mentioned that TCIs have a lot of utility, especially in the areas of the body she describes as more gentle.

“I want (attendees) to be aware of some of the medications they're using that perhaps have been a habit, as opposed to being something that there's true evidence for,” Young said. “And perhaps it is even recommended that it not be used in the pediatric population.”

For additional information on these topics, view the full interview segment posted above. View related conference coverage here.

The quotes contained here were edited for clarity. Young has received investigator fees, speaker fees, clinical research grants, and/or honoraria from AbbVie, Arcutis, Celgene, Lilly, Janssen, Merck/Sun, Novartis, and UCB.