Guttate psoriasis

• Guttate psoriasis:

  • Form of acute psoriasis
  • Described as a shower of small, pink-ref, scaly 'raindrops' that have fallen over the body
• Epidemiology:

  • Tends to affect children and young adults
  • Often the first presentation of psoriasis
  • Can also be seen in those with known chronic psoriasis
• Cause:

  • Typically develops 1-2 weeks after a streptococcal infection of the upper respiratory tract - particularly tonsillitis
• Clinical features:

  • Acute onset over days
  • Numerous small patches (<1cm)
  • Pink, scaly, then patches or plaques of psoriasis
  • Scale can be subtle in early lesions
  • Widespread lesions predominantly over the trunk and limbs
  • Lesions on the face, scalp, and ears tend to be faint and short-lived
• Diagnosis:

  • Clinical diagnosis aided by dermoscopy
  • Can be confirmed with skin biopsy
  • Throat swabs and ASOT bloods
• Management:

  • Can resolve spontaneously within a few months, but some cases can persist and develop into chronic plaque psoriasis
  • Treatment of underlying streptococcal infection
  • Topical corticosteroids
  • Emollients
  • Phototherapy