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Guttate Psoriasis may be described as an unusual and uncommon subtype of psoriasis.

What are the other Names for this Condition? (Also known as/Synonyms)

  • Eruptive Psoriasis

What is Guttate Psoriasis? (Definition/Background Information)

  • Guttate Psoriasis may be described as an unusual and uncommon subtype of psoriasis. Psoriasis is a common chronic inflammatory skin disease. It occurs due to a genetic defect, which causes the skin to grow faster than normal, resulting in white scaly patches and plaques on the skin
  • The onset of Guttate Psoriasis is often sudden and spontaneous, typically triggered by an infection. The skin condition is marked by small and red skin spots, mostly on the limbs and trunk. The scaly skin spots appear as teardrops (guttate, meaning “to resemble drops”)
  • The infections triggering Guttate Psoriasis may include bacterial infections (such as strep throat) and viral infections (including upper respiratory infections). Other triggers include skin trauma, insect bites, medications administered for malaria, stress, excess exposure to sunlight, and alcoholism
  • The treatment of Guttate Psoriasis is based on the severity of the presenting signs and symptoms. The treatment measures may include over-the-counter medications, administration of immunosuppressants that suppress the body's immune system to sunlight and phototherapy. With appropriate treatment, the prognosis of Guttate Psoriasis is generally good

Who gets Guttate Psoriasis? (Age and Sex Distribution)

  • Guttate Psoriasis is an uncommon type of psoriasis. The presentation of symptoms may occur during childhood or adulthood
  • Both males and females may be affected
  • Worldwide, individuals of all racial and ethnic groups may be affected

What are the Risk Factors for Guttate Psoriasis? (Predisposing Factors)

The risk factors for Guttate Psoriasis include:

  • Recent infections such as strep throat
  • Other bacterial/viral infections 
  • Stress
  • Sunburn
  • Alcoholism or excessive alcohol intake
  • Injury
  • Insect bites
  • Medications administered for malaria or certain heart conditions

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases one’s chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Guttate Psoriasis? (Etiology)

Guttate Psoriasis may be caused by the following factors (usually infections):

  • Antimalarial and heart medications
  • Bacterial infection
  • Strep throat
  • Certain viral infections
  • Upper respiratory infections
  • Excessive alcohol consumption
  • Stress
  • Sunburn
  • Trauma to the skin, such as cuts, burns, and insect bites

What are the Signs and Symptoms of Guttate Psoriasis?

The signs and symptoms of Guttate Psoriasis may include:

  • Presence of multiple small plaques on the skin; these are known to develop suddenly
  • The lesions are scaly and appear as teardrop-shaped (guttate) spots
  • These are mostly found on the limbs (arms and legs) and trunk (chest and back)
  • Faint plaques may be also observed on the face, ears and scalp

Additionally, the signs and symptoms of the underlying cause may be noted.

How is Guttate Psoriasis Diagnosed?

Guttate Psoriasis is diagnosed on the basis of the following information:

  • Physical examination of the individual and medical history evaluation
  • Assessment of the presenting signs and symptoms
  • Dermoscopy: Dermoscopy is a diagnostic tool where a dermatologist examines the skin using a special magnified lens
  • Wood’s lamp examination: In this procedure, the healthcare provider examines the skin using ultraviolet light. It is performed to examine the change in skin pigmentation
  • Skin biopsy, if necessary: A skin biopsy is performed and sent to a laboratory for a pathological examination. The pathologist examines the biopsy under a microscope. After putting together clinical findings, special studies on tissues (if needed) and with microscope findings, the pathologist arrives at a definitive diagnosis
  • Diagnostic tests to check for an underlying infection or causative condition

A differential diagnosis may be necessary to eliminate other conditions that present similar signs and symptoms.

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Guttate Psoriasis?

The complications of Guttate Psoriasis may include:

  • Emotional stress from cosmetic concerns
  • Secondary bacterial and fungal infections
  • Increased risk for scarring on skin if secondary infections develop
  • High blood pressure
  • Psoriasis arthritis
  • Development of malignancies
  • Cardiovascular disease
  • Crohn’s disease
  • Diabetes
  • Osteoporosis
  • Liver and kidney disease

Complications may occur with or without treatment, and in some cases, due to treatment also.

How is Guttate Psoriasis Treated?

The goal of treatment for Guttate Psoriasis is to control the symptoms and prevent secondary infections. These may include:

  • Antibiotics to clear streptococcus infection
  • Topical steroids (anti-itch and anti-inflammatory creams) 
  • Dandruff shampoos (over-the-counter or prescription)
  • Lotions that contain coal tar
  • Moisturizers
  • Phototherapy
  • Prescription medicines containing vitamin D or vitamin A (retinoids)
  • Immune-suppression with corticosteroids, cyclosporine, and methotrexate, in cases where the symptoms are severe
  • Treating the underlying cause, if any noted, is also important

Regular medical screening at periodic intervals with tests and physical examinations are recommended.

How can Guttate Psoriasis be Prevented?

  • Presently there are no guidelines or methods available for the prevention of Guttate Psoriasis.
  • However, seeking treatment for streptococcal or other bacterial/viral infections, and avoiding risk factors, such as excessive alcohol ingestion or sun exposure, may aid in controlling the triggers and minimizing severity of the symptoms

What is the Prognosis of Guttate Psoriasis? (Outcomes/Resolutions)

  • The prognosis of Guttate Psoriasis is good, since the condition either resolves on its own or following appropriate treatment (medications)
  • However, secondary infections may prolong time for recovery and may cause scarring

Additional and Relevant Useful Information for Guttate Psoriasis:

The following DoveMed website link is a useful resource for additional information:

https://www.dovemed.com/healthy-living/skin-disorders/

What are some Useful Resources for Additional Information?

American Academy of Dermatology
930 E. Woodfield Road Schaumburg, IL 60173
Phone: (866) 503-SKIN (7546)
Fax: (847) 240-1859
Website: http://www.aad.org

Genetic and Rare Diseases (GARD) Information Center
PO Box 8126 Gaithersburg, MD 20898-8126
Toll-Free: (888) 205-2311
TTY: (888) 205-3223
International Telephone Access Number: (301) 251-4925
Fax: (301) 251-4911
Website: http://rarediseases.info.nih.gov

National Psoriasis Foundation
6600 SW 92nd Ave., Suite 300 Portland, OR 97223
Phone: (800) 723-9166
Email: getinfo@psoriasis.org
Website: http://www.psoriasis.org

References and Information Sources used for the Article:

https://rarediseases.info.nih.gov/diseases/10569/guttate-psoriasis (accessed on 08/10/2021)

https://www.dermnetnz.org/topics/guttate-psoriasis/ (accessed on 08/10/2021)

Helpful Peer-Reviewed Medical Articles:

Naldi, L., Peli, L., Parazzini, F., Carrel, C. F., & Psoriasis Study Group of the Italian Group for Epidemiological Research in Dermatology. (2001). Family history of psoriasis, stressful life events, and recent infectious disease are risk factors for a first episode of acute guttate psoriasis: results of a case-control study. Journal of the American Academy of Dermatology, 44(3), 433-438.

Owen, C. M., Chalmers, R. J. G., O'sullivan, T., & Griffiths, C. E. M. (2001). A systematic review of antistreptococcal interventions for guttate and chronic plaque psoriasis. British Journal of Dermatology, 145(6), 886-890.

Costa-Romero, M., Coto-Segura, P., Suarez-Saavedra, S., Ramos-Polo, E., & Santos-Juanes, J. (2008). Guttate psoriasis induced by infliximab in a child with Crohn's disease. Inflammatory bowel diseases, 14(10), 1462-1463.

Herbst, R. A., Hoch, O., Kapp, A., & Weiss, J. (2000). Guttate psoriasis triggered by perianal streptococcal dermatitis in a four-year-old boy. Journal of the American Academy of Dermatology, 42(5), 885-887.

Koca, R., Altinyazar, H. C., Numanoglu, G., & Ünalacak, M. (2004). Guttate psoriasis-like lesions following BCG vaccination. Journal of tropical pediatrics, 50(3), 178-179.

Owen, C. M., Chalmers, R. J., O'Sullivan, T., & Griffiths, C. E. (2000). Antistreptococcal interventions for guttate and chronic plaque psoriasis. The Cochrane database of systematic reviews, (2), CD001976-CD001976.

Chalmers, R. J., O'Sullivan, T., Owen, C. M., & Griffiths, C. E. (2000). Interventions for guttate psoriasis. The Cochrane database of systematic reviews, (2), CD001213-CD001213.

Chalmers, R. J. G., O'sullivan, T., Owen, C. M., & Griffiths, C. E. M. (2001). A systematic review of treatments for guttate psoriasis. British Journal of Dermatology, 145(6), 891-894.

Krueger, J. G. (2002). The immunologic basis for the treatment of psoriasis with new biologic agents. Journal of the American Academy of Dermatology, 46(1), 1-26.