His skin cleared up after he started using ointment designed to fight psoriasis. But when he stopped applying the cream to his skin on a consistent basis, the disease returned with a vengeance and spread to his head, elbows, knees, back, face and ears.
"I wasn't crazy self-conscious. I had good friends. There weren't any social issues. But maintenance with the ointment presented challenges," said Crawford, who is now 17.
Crawford has since grown into a 6-foot-2-inch senior at Libertyville High School who plays on a lacrosse team and works out. And thanks to an effective medication, he no longer has psoriasis.
"Everything fell into place," he said.
Crawford was one of a number of young people who participated in a study run by his dermatologist, Dr. Amy Paller, to see if there is an association between obesity and psoriasis. Paller, who is chair of dermatology at Northwestern University's Feinberg School of Medicine, is the lead author of a paper about the matter, titled "Association of Pediatric Psoriasis Severity With Excess and Central Adiposity," that ran in the online edition of the Archives of Dermatology on Nov. 19.
The study "found a very strong association of psoriasis with excess adiposity," said Paller, using a scientific term for obesity. "There is a much higher percentage of children with psoriasis who are overweight or obese, than in children without it. We were able to show that, internationally, there is excess adiposity in about 38 percent of children with psoriasis and 20 percent in" those without the skin disorder.
The study's finding "suggests that if psoriasis is impacting central adiposity (causing weight gain) we should concurrently be helping children to develop a different lifestyle to slim down. You have to start early with kids to affect obesity," Paller said. A greater percentage of African-American and Hispanic children are overweight than children in other ethnic groups, she added.
The study also showed that "there is a much higher association in the United States than in other countries" between having psoriasis and being overweight or obese, perhaps due to environmental influences, Paller said.
The study looked at 409 children with psoriasis, ranging in age from five to 17, from nine countries between June 19, 2009, and Dec. 2, 2011. The study also examined the health of 205 who do not suffer from psoriasis.
The researchers measured the height, weight, waist circumference and blood pressure of the children with psoriasis.
Paller is also studying whether obesity leads to psoriasis, or whether the opposite is true.
Dr. Albert Yan, chief of pediatric dermatology at the Children's Hospital of Philadelphia and associate professor of pediatrics and dermatology at the University of Pennsylvania, called the study "well-designed."
"The key advantages to this particular study's design include its multicenter participation, relatively large numbers of enrolled patients (and) focus on children (for which there is relatively little information on this subject)," Yan said.
"This study links pediatric psoriasis to obesity, with convincing data to support this conclusion," he said. "Weight-loss combined with conventional psoriasis therapies appear to be more effective than using conventional psoriasis therapies alone. This might suggest that when treating kids with psoriasis who are obese, lifestyle changes to include weight loss might be helpful."
Crawford ended up on a regimen with six different ointments and a tar concoction, and then switched to a drug called methotrexate. It finally cleared up the problem.
"It's a big relief to not have to deal with that anymore," he said. "It's not an issue anymore."