It may affect a wide area of the body. This form of psoriasis is not common, accounting for less than 2% of all psoriasis cases. It is commoner in children and young adults under the age of 30. Both sexes are affected equally.
Causes of Guttate Psoriasis
Almost 80% of patients have a history of bacterial infection, typically streptococcal infection of tonsils or throat. Uncommonly, viral infections such as chickenpox, measles and rubella can also lead to it in children.
These infections trigger an immune reaction in the body whereby the white blood cells (which protect the body against infection) called T cells trigger an inflammation in skin and increase the production of the cells of skin. It can be inherited. Family history of the disease puts the person at greater risk of suffering from it.
Symptoms of Guttate Psoriasis
Small drop-like lesions that are red or salmon-pink in color appear on the skin 2 to 3 weeks following a streptococcal tonsillitis or sore throat. The lesions can be itchy. The lesions appear first on the arms, trunk or legs. They can spread to face or scalp. Palms and soles are usually spared. Nails do not show ridges and pits as usually occur in chronic psoriasis.
Medical attention is usually sought to get relief from itching or when the guttate psoriasis turns into chronic plaque-like psoriasis. Scarring is uncommon.
A dermatologist can easily diagnose the condition upon physical examination of the skin because of the typical lesions characterizing the disease. Skin biopsies are seldom necessitated to confirm the diagnosis. Antibodies in blood tests can point to a recent streptococcal infection, making the diagnosis more certain; they are present in over 50% of the patients.
Mild to moderate cases can be treated at home. Irritation and itching can be prevented by moisturizing the skin. Apply thick moisturizers following a bath to keep the skin moist and soft. Topical steroids can reduce the inflammation and hence relieve the itching.
Medical Treatment For Guttate Psoriasis
Guttate psoriasis usually resolves by itself within a few weeks even without treatment. Treatment depends on the level of severity and preferences of the individual. Not all patients may be comfortable using topical steroids over a large area of the body.
If throat culture is positive for streptococcal infection, it needs to be treated with appropriate antibiotics such as erythromycin, penicillin, or rifampicin. Ultraviolet light of the sunlight can slow down the production of skin cells and decrease the inflammation triggering mast cells.
So, short-course phototherapy can be prescribed. Psoralen-utraviolet A light (PUVA) therapy is found useful. Psoralen sensitizes the skin to sun. It is to be taken some hours before undergoing light therapy. Psoralen taken after meals reduces the side effects of nausea and vomiting.
Because psoralen sensitizes even the eyes to sunlight protective sunglasses need to be worn and avoid unnecessary exposure to sunlight for the duration of PUVA therapy. Tonsillectomy as a modality of treatment is still unproven.
Photo Credit: Mrsaskininfection.org/blog/tag/psoriasis-causes/