The goal of this retrospective observational study is to characterize the clinical features, severity, comorbidities, and treatment patterns of pediatric psoriasis in patients managed in the Costa Rican Social Security System. The main questions it aims to answer are:

What are the demographic and clinical characteristics of pediatric psoriasis in Costa Rica?

What disease severity profiles, comorbidities, and treatments are observed in routine care?

All patients <18 years with confirmed psoriasis evaluated during the study period will be included. Data will be obtained from electronic health records without intervention or modification of treatment.

Pediatric psoriasis is a chronic immune-mediated inflammatory dermatosis associated with physical, psychosocial, and metabolic comorbidity burden beginning early in life. Epidemiologic and clinical data in Latin American pediatric populations remain limited, particularly in real-world care settings. This study is a retrospective observational characterization of pediatric psoriasis patients managed in the Costa Rican Social Security System. Unlike interventional trials or biologic-specific registries, it analyzes existing clinical records to describe demographic distribution, clinical subtypes, severity (PASI/BSA/DLQI or pediatric indices), comorbidities, and treatment patterns in routine practice. No therapeutic interventions or standardized follow-up are introduced. By capturing real-world pediatric psoriasis presentation and management in Costa Rica, the study provides baseline national evidence distinct from drug-specific or prospective therapeutic studies.

Inclusion Criteria:

• Patients younger than 18 years at the time of psoriasis diagnosis.
• Clinical diagnosis of psoriasis established by a specialist physician (dermatologist or trained pediatrician) or by a general practitioner within the Costa Rican Social Security System (CCSS).
• Patients evaluated in CCSS healthcare facilities between January 2018 and December 2025.
• Clinical records containing sufficient information on key epidemiologic and therapeutic variables relevant to the study (age, sex, date of diagnosis, clinical subtype, and treatment received).

Exclusion Criteria:

• Patients aged 18 years or older at the time of psoriasis diagnosis.
• Clinical records incomplete or lacking sufficient information for analysis of the main study variables.
• Patients with uncertain or unconfirmed diagnosis of psoriasis.

All

The study population comprises children and adolescents (<18 years) with confirmed psoriasis managed in the Costa Rican Social Security System in Costa Rica. This retrospective hospital-based cohort includes patients across pediatric age groups and psoriasis subtypes receiving routine dermatologic care. Data derived from electronic health records and reflect real-world pediatric psoriasis severity, comorbidities, and treatment patterns in specialized tertiary care without protocol-mandated interventions.

According to the protocol