{"id":42710,"date":"2016-06-24T14:03:05","date_gmt":"2016-06-24T18:33:05","guid":{"rendered":"http:\/\/piel-l.org\/blog\/?p=42710"},"modified":"2016-06-24T20:08:07","modified_gmt":"2016-06-25T00:38:07","slug":"psoriasis-en-la-infancia-tratamiento-sistemico","status":"publish","type":"post","link":"https:\/\/piel-l.org\/blog\/42710","title":{"rendered":"Psoriasis en la Infancia: Tratamiento Sist\u00e9mico"},"content":{"rendered":"<p><strong>Fototerapia<\/strong><\/p>\n<ul>\n<li class=\"li1\"><span class=\"s2\">UVB-NB es efectiva y bien tolerada tanto en Psoriasis en placa como en la guttate<\/span><\/li>\n<li class=\"li1\"><span class=\"s2\">UVA-Psoralen (PUVA) puede ser usada en adolescentes<\/span><\/li>\n<li class=\"li1\"><span class=\"s2\">Puede observarse eritema, quemaduras, ampollas, prurito como efectos colaterales<\/span><\/li>\n<li class=\"li2\"><span class=\"s2\">La ansiedad puede tambi\u00e9n observarse en ni\u00f1os\u00a0<\/span><\/li>\n<\/ul>\n<p class=\"p1\"><strong><span class=\"s1\">Metotrexate<\/span><\/strong><\/p>\n<ul>\n<li class=\"li1\"><span class=\"s2\">Metotrexate oral o subcut\u00e1neo ha demostrado eficacia en la forma moderada o severa<\/span><\/li>\n<li class=\"li1\"><span class=\"s2\">Dosis de 5-10 mgrs en menores de 10 a\u00f1os, en mayores dosis de 7,5 a 15 mgrs, una dosis semanal<\/span><\/li>\n<li class=\"li2\"><span class=\"s2\">Siempre debe administrarse acido f\u00f3lico 48 horas despu\u00e9s para disminuir efectos colaterales<\/span><\/li>\n<\/ul>\n<p class=\"p1\"><strong><span class=\"s1\">Ciclosporina<\/span><\/strong><\/p>\n<ul>\n<li class=\"li1\"><span class=\"s2\">La evidencia en ni\u00f1os es limitada<\/span><\/li>\n<li class=\"li1\"><span class=\"s2\">Debido a los efectos colaterales debe usarse dosis baja y periodos mas cortos<\/span><\/li>\n<li class=\"li1\"><span class=\"s2\">Control estricto de tensi\u00f3n arterial y funcionalismo renal<\/span><\/li>\n<li class=\"li2\"><span class=\"s2\">Debe obviarse fototerapia concomitante para disminuir riesgo de c\u00e1ncer de piel<\/span><\/li>\n<\/ul>\n<p class=\"p1\"><strong><span class=\"s1\">Retinoides<\/span><\/strong><\/p>\n<ul>\n<li class=\"li1\"><span class=\"s2\">Eficaz en Psoriasis pustulosa y eritrod\u00e9rmica<\/span><\/li>\n<li class=\"li1\"><span class=\"s2\">Debe vigilarse funcionalismo hep\u00e1tico y triglic\u00e9ridos<\/span><\/li>\n<li class=\"li1\"><span class=\"s2\">Su uso prolongado ha sido relacionado con hiperostosis difusa y cierre prematuro de ep\u00edfisis<\/span><\/li>\n<li class=\"li2\"><span class=\"s2\">Recordar en adolescentes evitar embarazo hasta 3 a\u00f1os despu\u00e9s de suspender<\/span><\/li>\n<\/ul>\n<p class=\"p1\"><strong><span class=\"s1\">Terapia Biol\u00f3gica<\/span><\/strong><\/p>\n<ul>\n<li class=\"li1\"><span class=\"s2\">En ni\u00f1os est\u00e1n aprobados el Etanercept y Adalimumab<\/span><\/li>\n<li class=\"li1\"><span class=\"s2\">Al igual que en el adulto han sido<span class=\"Apple-converted-space\">\u00a0 <\/span>asociados a infecciones<span class=\"Apple-converted-space\">\u00a0 <\/span>oportunistas, reactivaci\u00f3n de Tuberculosis y linfomas<\/span><\/li>\n<li class=\"li1\"><span class=\"s2\">En investigaciones recientes se se\u00f1ala su uso mas seguro que el Metotrexate <\/span><\/li>\n<li class=\"li2\"><span class=\"s2\">Sin embargo su uso debe ser considerado de tercera l\u00ednea<\/span><\/li>\n<\/ul>\n<p class=\"p1\"><strong><span class=\"s1\">Conclusi\u00f3n<\/span><\/strong><\/p>\n<ul>\n<li class=\"li1\"><span class=\"s2\">Psoriasis en el ni\u00f1o est\u00e1 incrementando<\/span><\/li>\n<li class=\"li1\"><span class=\"s2\">Debe vigilarse y estudiar presencia de comorbilidades<\/span><\/li>\n<li class=\"li1\"><span class=\"s2\">El componente emocional involucra tanto al ni\u00f1o como a los representantes<\/span><\/li>\n<li class=\"li2\"><span class=\"s2\">Debe establecerse una buena relaci\u00f3n m\u00e9dico-paciente-n\u00facleo familiar para obtener mejores resultados<\/span><\/li>\n<\/ul>\n","protected":false},"excerpt":{"rendered":"<p>UVB-NB es efectiva y bien tolerada tanto en Psoriasis en placa como en la guttate<\/p>\n","protected":false},"author":104,"featured_media":42711,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[620],"tags":[],"class_list":["post-42710","post","type-post","status-publish","format-standard","has-post-thumbnail","","category-psoriasis-en-nino"],"_links":{"self":[{"href":"https:\/\/piel-l.org\/blog\/wp-json\/wp\/v2\/posts\/42710","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/piel-l.org\/blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/piel-l.org\/blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/piel-l.org\/blog\/wp-json\/wp\/v2\/users\/104"}],"replies":[{"embeddable":true,"href":"https:\/\/piel-l.org\/blog\/wp-json\/wp\/v2\/comments?post=42710"}],"version-history":[{"count":0,"href":"https:\/\/piel-l.org\/blog\/wp-json\/wp\/v2\/posts\/42710\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/piel-l.org\/blog\/wp-json\/wp\/v2\/media\/42711"}],"wp:attachment":[{"href":"https:\/\/piel-l.org\/blog\/wp-json\/wp\/v2\/media?parent=42710"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/piel-l.org\/blog\/wp-json\/wp\/v2\/categories?post=42710"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/piel-l.org\/blog\/wp-json\/wp\/v2\/tags?post=42710"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}