Psoriasis - guttate
Psoriasis - guttate; Group A streptococcus - guttate psoriasis; Strep throat - guttate psoriasis
Guttate psoriasis is a skin condition in which small, red, scaly, teardrop-shaped spots with silvery scale appear on the arms, legs, and middle of the body. Gutta means "drop" in Latin.
Guttate psoriasis is a type of psoriasis. Guttate psoriasis is usually seen in people younger than 30, especially in children. The condition often develops suddenly. It usually appears after an infection, most notably strep throat caused by group A streptococcus. Guttate psoriasis is not contagious. This means it can't spread to other people.
Psoriasis is a common disorder. The exact cause isn't known. But doctors think genes and the immune system are involved. Certain things can trigger an attack of symptoms.
With guttate psoriasis, in addition to strep throat, the following may trigger an attack:
- Bacteria or viral infections, including upper respiratory infections
- Injury to the skin, including cuts, burns, and insect bites
- Some medicines, including those used to treat malaria and certain heart conditions
- Too much alcohol
Psoriasis may be severe in people who have a weakened immune system. This may include people who have:
Psoriasis is a common skin condition that causes skin redness and irritation. Most people with psoriasis have thick, red skin with flaky, silver-white patches called scales. Psoriasis may affect you at any age, but it usually begins between the ages of 15 and 35. You can't spread this disorder to others, but it does seem to be passed down through families. We think it probably occurs when your immune system mistakes healthy cells for dangerous substances. Skin cells grow deep in your skin, normally rising to the surface about once a month. But, in people with psoriasis, this process occurs too fast, usually happening in only about 2 weeks, and dead skin cells build up on your skin's surface. Many factors can trigger psoriasis, or make it more difficult to treat, including bacterial or viral infections, dry air or skin, injuries to your skin, some medications, stress, too much or too little sunlight, and even too much alcohol. In general, psoriasis may be very bad in people who have a weakened immune system. Psoriasis can appear suddenly or it can appear slowly. Often, it goes away and then flares up again, time after time. If you have psoriasis, you'll probably have irritated patches of skin on your body, often on your elbows and knees. But it can show up anywhere on your body, even your scalp. The skin patches may be itchy, dry and covered with silver, flaky scales. They may be pink in color and raised and thick. So, what do you do about psoriasis? Well, your doctor will need to look at your skin to make a diagnosis. Sometimes the doctor will take a skin sample, or a biopsy, to rule out other possible problems. Your treatment will focus on controlling your symptoms and preventing infections. In general, you have three options topical medications like lotions or creams, pills or injections that affect your whole body, and therapy that uses light to treat psoriasis. But most people tend to use creams or ointments they place directly on their skin. Psoriasis is a life-long condition you can control with treatment. It may go away for a long time and then suddenly return. Fortunately, with the right treatment, it usually does not affect your general physical health.
Symptoms may include:
- Spots on the skin that are pinkish-red and look like teardrops
- Spots may be covered with silver, flaky skin called scales
- Spots usually occur on the arms, legs, and middle of the body (the trunk), but may appear in other body areas
Exams and Tests
Your health care provider will look at your skin. Diagnosis is usually based on what the spots look like.
Often, a person with this type of psoriasis has recently had a sore throat or upper respiratory infection.
Tests to confirm the diagnosis may include:
- Skin biopsy
- Throat culture
- Blood tests for recent exposure to strep bacteria
If you are recently infected, your provider may give you antibiotics.
Mild cases of guttate psoriasis are usually treated at home. Your provider may recommend any of the following:
- Cortisone or other anti-itch and anti-inflammatory creams
- Dandruff shampoos (over-the-counter or prescription)
- Lotions that contain coal tar
- Prescription medicines that have vitamin D to apply to the skin (topically) or that have vitamin A (retinoids) to take by mouth (orally)
People with very severe guttate psoriasis may receive medicines to suppress the body's immune response. These include cyclosporine and methotrexate. A newer group of medicines called biologicals that alter parts of the immune system may also be used.
Your provider may suggest phototherapy. This is a medical procedure in which your skin is carefully exposed to ultraviolet light. Phototherapy may be given alone or after you take a medicine that makes the skin sensitive to light.
Guttate psoriasis may clear completely following treatment, especially phototherapy treatment. Sometimes, it may become a chronic (lifelong) condition, or worsen to the more common plaque-type psoriasis.
When to Contact a Medical Professional
Call your provider if you have symptoms of guttate psoriasis.
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Lebwohl MG, van de Kerkhof P. Psoriasis. In: Lebwohl MG, Heymann WR, Berth-Jones J, Coulson IH, eds. Treatment of Skin Disease: Comprehensive Therapeutic Strategies. 5th ed. Philadelphia, PA: Elsevier; 2018:chap 210.
Last reviewed on: 4/16/2019
Reviewed by: Michael Lehrer, MD, Clinical Associate Professor, Department of Dermatology, University of Pennsylvania Medical Center, Philadelphia, PA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.