Psoriasis (guttate)

Guttate psoriasis often follows acute group B haemolytic streptococcal pharyngitis in persons genetically predisposed to psoriasis. It accounts for 2% of the total cases of psoriasis (1). In a majority of patients it is a self limiting condition (2).

The clinical features include:

• presents with salmon pink, dew drop like papules (3)
• numerous, small, round psoriatic lesions - less than 1 cm diameter (1)
• number of lesions can vary (from 5 or 10 to over 100) (1)
• lesions develop acutely and usually has a centripetal distribution pattern (over trunk) but may involve the head and limbs (1)
• often erupts suddenly following infection - may rapidly disappear or form stable plaques
• may itch, initially
• clinically distinguished from pityriasis rosea because pityriasis rosea is a lighter pink colour with scaling confined to the edges of individual lesions
• acute episodes in children are usually self limiting, but in adults it may complicate chronic plaque disease (1)

Click here for example images of guttate psoriasis

Reference:

• 1. Langley R.G.B et al. Psoriasis: epidemiology, clinical features, and quality of life. Annals of the Rheumatic Diseases 2005;64(2)
• 2. The British Association of Dermatologists 2008. General management of Psoriasis -Specific sites
• 3. American Academy of Dermatology 2008. Guidelines of care for the management of psoriasis and psoriatic arthritis - Section 1. Overview of psoriasis and guidelines of care for the treatment of psoriasis with biologics