Pediatric onset of psoriasis occurs in up to one third of psoriasis patients. Although the majority of pediatric patients with plaque psoriasis have mild disease that can be controlled with topical therapy alone, more severe cases can require systemic therapy. Although no clinical trials of ustekinumab have been performed in a pediatric population, its success in treating moderate to severe psoriasis in adults led us to use this drug in a child who had previously experienced treatment failure with etanercept and adalimumab.
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