Background The COVID‐19 pandemic has raised questions regarding the management of chronic skin diseases, especially in patients on systemic treatments. Data concerning the use of biologics in adults with psoriasis are reassuring, but data specific to children are missing. Moreover, COVID‐19 could impact the course of psoriasis in children. Objectives The aim of this study was therefore to assess the impact of COVID‐19 on the psoriasis of children, and the severity of the infection in relation to systemic treatments. Methods We set up an international registry of paediatric psoriasis patients. Children were included if they were under 18 years of age, had a history of psoriasis, or developed it within 1 month of COVID‐19 and had COVID‐19 with or without symptoms. Results One hundred and twenty episodes of COVID‐19 in 117 children (mean age: 12.4 years) were reported. The main clinical form of psoriasis was plaque type (69.4%). Most children were without systemic treatment (54.2%); 33 (28.3%) were on biologic therapies, and 24 (20%) on non‐biologic systemic drugs. COVID‐19 was confirmed in 106 children (88.3%) and 3 children had two COVID‐19 infections each. COVID‐19 was symptomatic for 75 children (62.5%) with a mean duration of 6.5 days, significantly longer for children on non‐biologic systemic treatments ( P = 0.02) and without systemic treatment ( P = 0.006) when compared with children on biologics. The six children who required hospitalization were more frequently under non‐biologic systemic treatment when compared with the other children ( P = 0.01), and particularly under methotrexate ( P = 0.03). After COVID‐19, the psoriasis worsened in 17 cases (15.2%). Nine children (8%) developed a psoriasis in the month following COVID‐19, mainly a guttate form ( P = 0.01). Discussion Biologics appear to be safe with no increased risk of severe form of COVID‐19 in children with psoriasis. COVID‐19 was responsible for the development of psoriasis or the worsening of a known psoriasis for some children.

Psoriasis is chronic inflammatory skin disease that can develop at any age. Approximately 20–30% of all patients report about first rashes before the age of 18. Psoriatic arthritis is one of psoriasis comorbid conditions. Its signs can range from mild to extremely severe destructive forms. Arthralgia, joint stiffness and swelling are the most common symptoms. Early psoriatic arthritis treatment onset allows to control joint damage which usually occurs during the first 2 years of the disease. The moderate and severe course of psoriasis and psoriatic arthritis may require systemic therapy, however, there is not much data on the efficacy and toxicity of systemic agents in the pediatric practice. This article provides the review of studies on etanercept efficacy and safety in children with psoriatic arthritis.