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87?�� 974.20. The cost ranged from ��5.11 (one prescription of hydrocortisone) to ��28,182.27 (five prescriptions of biologic agents). Juvenile psoriasis was associated with a higher rate of comorbidity than in individuals without psoriasis. The prevalence of the comorbidities was (Fig.?4) rheumatoid arthritis and inflammation, 2.1% (non-psoriatic patients 0.1%); delirium, psychosis, psychotic and dissociative disorder, 1.1% (0.4%); depressive episodes, 0.7% (0.2%); heart valve disease and rheumatic heart disease, 0.6% (0.3%); congenital heart disease, 0.6% (0.4%); serious endocrine disease and metabolic disease (including lysosomal storage diseases: ICD E72�CE77), 0.4% (0.2%); and hypertonia, 0.3% (0.1%). Children and young adults with psoriasis had on average 0.22?��?0.54 comorbidities, compared with 0.14?��?0.44 [http://www.selleckchem.com/products/torin-1.html mTOR inhibitor] comorbidities in children and young adults without psoriasis. After adjusting for age and sex, patients with psoriasis had a significantly higher number of comorbidities than patients without psoriasis (p?[http://www.selleckchem.com/products/BAY-73-4506.html Selleckchem Regorafenib] it difficult to establish a reliable diagnosis at this age [16]. Estimates of the total prevalence of psoriasis in childhood vary from 0.1% to 3.0% [17, 18]. Using data from several German SHI organizations, the present study showed that psoriasis is more common in children than has been documented previously. To aid comparisons with other methodologically similar studies [18], prevalence was calculated separately for ages 0 to 9 years (0.18%) and 10 to 19 years (0.83%). The prevalence of psoriasis in the present study population also underlines results of an earlier study from Germany that found a prevalence of 0.37% in children age 0 to 9 years and 1.01% in children age 10 to 19 years [11]. The study results are also somewhat consistent with those of another from the Netherlands (age 0�C10 years, 0.4%; age 11�C19, 1.0%) [10] and a study from the United Kingdom (age 0�C9 years, 0.55%; age 10�C18 years, 1.37%) [1]. Preliminary results from a 2009 study using routine German SHI with almost 300,000 children and adolescents also show a similar prevalence of psoriasis in those age 18 years and younger (0.45%) [18]. Although the prevalence of other common dermatologic conditions, such [https://en.wikipedia.org/wiki/Floctafenine Floctafenine] as acne and atopic eczema, is higher than that of juvenile psoriasis [11], our study highlights that juvenile psoriasis is common in children and adolescents. This study found that the treatment of psoriasis in childhood is conservative, with most children and adolescents treated using topical corticosteroids or antipsoriatics. This could be a result of uncertainty over appropriate therapy in juvenile patients resulting in prescribers opting to use a conservative therapy with a lower risk of long-term side effects.