GUTTATE PSORIASIS

Guttate psoriasis (GP) is a variant of psoriasis that appears as a diffuse eruption of small, red, scaly papules. It commonly is triggered by Strep throat. Guttate means "rain drop".

• GP typically affects children and young adults, with the majority of cases occurring before the age of 30.
  
• Classically GP follows Strep throat. Studies showing that 60-80% of patients have clinical or laboratory evidence of a Strep infection.
• Other triggers include respiratory viral infections, Covid-19 and vaccination for Covid-19.
• GP usually resolves over several months, and may be helped to clear by UV exposure.
• Patients are at risk in the future to develop classic plaque-type psoriasis. The most recent stugy puts the risk at 12% within 5 years. Those with a positive Strep culture are less likely to develop plaque psoriasis.
  
• Guttate psoriasis is the most common type of psoriasis in children. If often remits spontaneously.

The sudden development of disseminated 0.5 - 2.0 cm. red, scaly papules or small plaques is characteristic. A streptococcal infection is a very common precipitant. One should inquire about a preceding sore throat, measure the ASO and take culture of the nose and throat. Perianal cellulitis has precipitated guttate psoriasis in children.

Differential Diagnosis

Secondary syphilis should be considered. Usually, this involves the palms and soles. Pityriasis rosea can look similar in the early stages. The presence of a herald patch helps here.

RegionalDerm

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