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[Comment] Adalimumab in paediatric psoriasis

Psoriasis is an immune-mediated chronic disease affecting the skin and joints and multiple other organs including the heart.1 Although it affects about 2% of the population worldwide,2 the prevalence of paediatric psoriasis is 0·70%,3 as most patients initially present with the disease in adulthood. There is a paucity of approved systemic therapies for the management of paediatric psoriasis. Systemic treatments include, among others, methotrexate, ciclosporin, acitretin,4 etanercept (a tumour necrosis factor [TNF]-α antagonist approved by the US Food and Drug Administration in November, 2016, to treat moderate to severe psoriasis in children aged 4–17 years), and adalimumab (another TNF-α antagonist approved in 2015 by the European Medicines Agency for the treatment of severe plaque psoriasis in children aged 4 years or older).