Psoriasis, Guttate: eMedicine Dermatology

Psoriasis, Guttate: eMedicine Dermatology

Guttate psoriasis primarily occurs on the trunk and the proximal extremities, but it may have a generalized distribution. New guttate psoriasis lesions develop during the first month of disease, they remain stable during the second month, and the remission begins during the third month.1 The word guttate is derived from the Latin word gutta, meaning drop.

Guttate psoriasis is more common in individuals younger than 30 years, and a history of upper respiratory tract infection secondary to group A beta-hemolytic streptococci (eg, Streptococcus pyogenes) often precedes the eruption by 2-3 weeks.2 Streptococcal perianal dermatitis, a superficial bacterial infection of the anus and perianal skin in children, has also been linked with the appearance of guttate psoriasis.3,4 Although episodes may recur, especially those due to pharyngeal carriage of streptococci, isolated bouts have also been described. The sudden appearance of the papular lesions in response to streptococcal infection may be either the first manifestation of psoriasis in a previously unaffected individual or an acute exacerbation of long-standing plaque psoriasis. Uncommonly, guttate psoriasis may be chronic in nature and/or arise in the absence of preceding streptococcal infection.