Guttate Psoriasis
by Edward F. Group III, DC, ND, DACBN
updated on 04/28/2006 at 05:14PM
Psoriasis is a chronic condition that affects roughly three percent of the population in the United States. It occurs as the result of a rapid generation of skin cells that allows patches of reddened and inflamed lesions to form. There are several different types of psoriasis that are defined by the location and appearance of these lesions. Varieties of psoriasis include plaque psoriasis, pustular psoriasis, scalp psoriasis, nail psoriasis, and guttate psoriasis. This article will focus on the latter of these conditions, detailing the appearance, causes, and treatment for guttate psoriasis.
What Is Guttate Psoriasis?
Guttate psoriasis is a rare form of psoriasis that is usually seen in patients less than thirty years of age. The lesions of this type of psoriasis look like small, red, localized drops on the skin. In fact, the term guttate comes from that Latin word gutta meaning “drop.” Guttate psoriasis usually starts on the trunk, arms, or legs and sometimes spreads to the face, ears, or scalp.
The palms and the bottoms of the feet are usually not affected. Occasionally, it may also appear on the scalp. This skin condition causes pain, itching and the possibility of secondary skin infections. Like other forms of psoriasis, guttate psoriasis has the tendency to worsen during the winter and improve during the summer. This condition usually appears for the first time in childhood or young adulthood. It usually comes on very quickly, usually within a couple of days. After the initial bout of guttate psoriasis, recurrent episodes may occur throughout the sufferer’s life. However, in most cases, once the condition clears up, it will not return.
Who Gets Guttate Psoriasis?
Guttate psoriasis affects both males and females of all races. It can occur at any age, although it most often strikes individuals younger than thirty years of age, and it is generally believed to be the type of psoriasis most likely to affect children and adolescents. In the United States, guttate psoriasis occurs in less than two percent of psoriasis cases. Internationally, this type of psoriasis occurs in two to four percent of psoriasis cases.
What Causes Guttate Psoriasis?
Guttate psoriasis often erupts quite suddenly. It may be triggered by an injury or infection. In fact it is often associated with strep throat, a bacterial infection of the throat. Other illnesses that may trigger an attack of guttate psoriasis include tonsillitis, a common cold, or chicken pox. Vaccinations, physical trauma, psychological stress, and antimalarial drugs have also been associated with the onset of guttate psoriasis.
How Is Guttate Psoriasis Diagnosed?
There are no specific medical tests or procedures that can be used to diagnosis guttate psoriasis. In most cases, your health care provider will make his or her diagnosis based on the combination of history, clinical appearance of the rash, and evidence of a preceding infection (such as strep throat.). If there is a question, our health care provider may order a biopsy to look more closely examine the skin for the presence of guttate psoriasis. Your doctor may also order a blood test to confirm the presence of increased levels of antibodies to streptolysin-O. This increased level of antibodies is common in patients who have recently suffered from strep throat, and they are present in more than one half of patients with guttate psoriasis.
How Is Guttate Psoriasis Treated?
In most cases, guttate psoriasis lesions will last for a few weeks or months, and then clear up on their own. However, without treatment, guttate psoriasis may progress into plaque psoriasis, a more common and longer-lasting form of the disease. This progression occurs in about seventy percent of guttate psoriasis patients. Treatment options for guttate psoriasis include antibiotics, topical preparations, ultraviolet light therapy, and systemic medications. I do not recommend using antibiotics, chemical based creams or medications.
Antibiotics can help prevent an infection from re-occurring and causing an outbreak of guttate psoriasis.
Topical Preparations such as moisturizers, coal tar, corticosteroids, synthetic vitamin D3 derivatives, and retinoids can be applied to the skin to reduce redness and relieve the pain and itching that is associated with the condition.
Ultraviolet Light Therapy Your health care provider may prescribe either natural light therapy, or sessions using artificial ultraviolet light to ease guttate psoriasis.
Systemic Medications such as cyclosporine, methotrexate, Soriatane, Accutane, Hydrea, mycophenolate mofetil, sulfasalazine, and 6-Thioguanine, may be prescribed by a health care provider to provide immediate but short term relief for troublesome cases of the condition.
Patients who suffer from guttate psoriasis must also be careful to minimize other forms of trauma to the skin such as scratching, cuts, or vigorous rubbing. This type of trauma can lead to the development of new psoriatic lesions on areas that were previously unaffected by the condition. When psoriasis occurs as the result of a trauma to the skin, it is known as the Koebner response.
