Guttate Psoriasis

What is psoriasis in general?

Psoriasis is a skin disease that causes itchy or sore patches of thick, red skin topped with silvery scales. These patches are usually on the elbows, knees, scalp, or back, but they can occur anywhere on the body. Some people with psoriasis also get a form of arthritis, called psoriatic arthritis.

What is guttate psoriasis?

Guttate means “drop” in Latin; thus, guttate psoriasis is a form of psoriasis where the patches of scaly skin are in small, teardrop-shaped spots. These spots most often appear on the legs, arms, and trunk of the body, but again, they can appear anywhere. Guttate psoriasis is usually seen in people under the age of 30 and is especially severe in those who have a weakened immune system. The condition may clear completely after treatment, but sometimes it may become a chronic condition and/or worsen to the more common plaque psoriasis.

What are the symptoms of guttate psoriasis?

Symptoms of guttate psoriasis include:

• Itching
• Dandruff
• Pinkish-red spots on the skin, possibly covered with silver, flaky skin

What causes guttate psoriasis?

Like general psoriasis, guttate psoriasis is caused by a problem in one’s immune system, so it is not contagious. In a process called cell turnover, skin cells that grow deep in your skin rise to the surface. Normally, this cell turnover process takes about a month, but in psoriasis, the body’s immune system mistakes healthy cells for harmful substances, and cell turnover happens in mere days. Doctors think that this immune response is genetic and passed down through families. Guttate psoriasis flare ups often develop suddenly and usually appear after an infection. The most notable infection linked to guttate psoriasis is strep throat caused by group A strep, but any of the following may also trigger a flare up:

• Bacteria or viral infections
• Injury to the skin, such as cuts or burns
• Some medications, including those used to treat malaria
• Stress
• Excess alcohol consumption

How is guttate psoriasis diagnosed?

To diagnose psoriasis, a doctor will look at your skin and examine the plaques, as well as inquire on basic medical/family history. Often, a person with this type of psoriasis recently has had an upper respiratory infection. Guttate psoriasis is often misdiagnosed for other skin conditions such as eczema, so it is important to go to a dermatologist if you suspect psoriasis. Skin biopsies and throat cultures can also be used to help confirm a diagnosis.

What are the treatments for guttate psoriasis?

Since psoriasis is an incurable condition, the goal of treatment is to control symptoms and prevent any secondary infections. If you have a current or have had a recent infection, antibiotics may be prescribed. For mild cases of guttate psoriasis, symptoms can be treated at home using any of the following:

• Cortisone (anti-itch/anti-inflammatory) cream
• Dandruff shampoos
• Coal-tar lotions
• Moisturizers
• Topical prescription medications that have vitamin D
• Corticosteroid topical medications

Phototherapy, which is a medical procedure that exposed the skin to ultraviolet light, may also be used for more widespread guttate psoriasis. For more severe cases of guttate psoriasis, doctors may try to treat the condition internally, using medications to try and suppress the body’s immune system:

• Cyclosporine
• Methotrexate
• Biologics, such as Humira

Steroid injections and joint replacement surgery are other options.

Where can I find out more about guttate psoriasis?

• Mayo Clinic
• Medline Plus
• NIH
• National Psoriasis Foundation