Psoriasis - guttate

Psoriasis, guttate on the arms and chest

This is a picture of guttate (drop-shaped) psoriasis on the arms and chest. Guttate psoriasis is a rare form of psoriasis. It frequently follows a streptococcal infection, appears rapidly and affects the face, chest, and nearest limbs. The patches are small and round or oval and have the typical appearance of psoriasis. This photograph shows the diffuse and widespread coverage on the arm and chest.

Also known as: Guttate psoriasis

Definition

Guttate psoriasis is a skin condition in which small, red, teardrop-shaped spots appear on the arms, legs, and middle of the body. Guttate means "drop" in Latin.

See also: Psoriasis

Causes, incidence, and risk factors

Guttate psoriasis is a relatively uncommon form of psoriasis. It is usually seen in patients younger than 30. The condition often develops very suddenly, usually after an infection, most notably strep throat. Guttate psoriasis is not contagious.

Psoriasis seems to be an inherited disorder. That means it is passed down through families. Doctors think it probably occurs when the body's immune system mistakes healthy cells for dangerous substances. See: Inflammatory response

In addition to strep throat, the following may trigger an attack of guttate psoriasis:

  • 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
  • Stress
  • Sunburn
  • Too much alcohol

In general, psoriasis may be severe in persons who have a weakened immune system. This may include persons who have:

Symptoms

Symptoms include itching and spots on the skin, called skin lesions, which are pinkish-red and look like teardrops. The spots may be covered with silver, flaky skin called scales.

The spots usually occur on the arms, legs, and middle of the body (the trunk), but may appear in other body areas.

Signs and tests

Your doctor 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 include:

  • Skin biopsy
  • Throat culture

Treatment

The goal of treatment is to control your symptoms and prevent secondary infections.

If you have an infection, your doctor may give you antibiotics.

Mild cases of guttate psoriasis are usually treated at home. Your doctor may recommend any of the following:

  • Cortisone (anti-itch) cream
  • Dandruff shampoos (over-the-counter or prescription)
  • Lotions that contain coal tar
  • Moisturizers
  • Prescription medicines containing vitamin D or vitamin A (retinoids)

Persons with very severe guttate psoriasis may receive medicines to suppress the body's immune response. These medicines include corticosteroids, cyclosporine, and methotrexate.

Sunlight may help your symptoms go away. Be careful not to get sunburn. Some people may choose to have phototherapy. Phototherapy is a medical procedure in which your skin is carefully exposed to ultraviolet light. Phototherapy may be given alone or after you take a drug that makes the skin sensitive to light.

Expectations (prognosis)

Guttate psoriasis may clear completely following treatment. Sometimes, however, it may become a chronic (lifelong) condition, or worsen to the more common plaque-type psoriasis.

Complications

  • Pain
  • Secondary skin infections
  • Severe itching

Calling your health care provider

Call your health care provider if you have symptoms of guttate psoriasis.

References

van de Kerkhof PCM, Schalkwijk J. Psoriasis. In: Bolognia JL, Jorizzo JL, Rapini RP, eds.: Dermatology. 2nd ed. Philadelphia, Pa: Mosby Elsevier; 2008: chap 9.

See also:

  • Disease

    Immunodeficiency disorders

    Antibodies

    Immunodeficiency disorders occur when the body’s immune response is reduced or absent. See also:

  • Disease

    Rheumatoid arthritis

    Rheumatoid arthritis

    Rheumatoid arthritis (RA) is a long-term disease that leads to inflammation of the joints and surrounding tissues. It can also affect other organs.

  • Injury

    Insect bites and stings

    Bedbug - close-up

    Insect bites and stings can cause an immediate skin reaction. The bite from fire ants and the sting from bees, wasps, and hornets are usually painful. Bites caused by mosquitoes, fleas, and mites are more likely to cause itching than pain.

  • Disease

    Autoimmune disorders

    Graves' disease

    An autoimmune disorder is a condition that occurs when the immune system mistakenly attacks and destroys healthy body tissue. There are more than 80 different types of autoimmune disorders. See also:

  • Injury

    Burns

    First degree burn

    There are three levels of burns: First-degree burns affect only the outer layer of the skin. They cause pain, redness, and swelling. Second-degree (partial thickness) burns affect both the outer and underlying layer of skin. They cause pain, redness, swelling, and blistering. Third-degree (full ...

  • Symptoms

    Scales

    Lichen planus - close-up

    Scales are a visible peeling or flaking of outer skin layers.

  • Disease

    Psoriasis

    Psoriasis on the knuckles

    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 . See also:

  • Disease

    AIDS

    Kaposi's sarcoma - lesion on the foot

    AIDS (acquired immune deficiency syndrome) is the final stage of , which causes severe damage to the immune system.

  • Special Topic

    Immune response

    Immune system structures

    The immune response is how your body recognizes and defends itself against bacteria, viruses, and substances that appear foreign and harmful.

  • Symptoms

    Rashes

    Poison oak rash on the arm

    Rashes involve changes in the color or texture of your skin.

Review date:
June 17, 2009
Reviewed by:
Michael Lehrer, MD, 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, A.D.A.M., Inc.
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