Guttate psoriasis is a less common form of the skin condition – just 2% or so of psoriasis sufferers have guttate psoriasis. This type of psoriasis is so called due to the small, pinkish drops on the skin (‘gutta’ means ‘drop’ in Latin), mainly seen on the torso, arms and legs.
The scaling of the skin is much lighter than in plaque psoriasis, the most common form of the skin disorder. Whilst not contagious, guttate psoriasis can be triggered by a bacterial infection, usually streptococcus (strep throat). The outbreak of psoriasis two to three weeks after having strep throat may be an isolate incidence or it can recur or remain, particularly if the person carries strep in their respiratory system. Chicken pox or even the common cold can cause guttate psoriasis and the skin condition may occur in those who also suffer from plaque psoriasis.
Those under thirty years old are more likely to suffer from guttate psoriasis, and both men and women are affected equally. The finer scaling of the skin and the pink raindrop pattern can arise in the face, hands, and in the groin or genital region. Guttate psoriasis may flare-up when the patient has an infection, is stressed or due to environmental or dietary factors. Common signs of guttate psoriasis include:
- itchy, small, pink (or red) raindrop-shape scales on the skin
- the condition appears quickly 2-3 weeks after strep throat, tonsillitis or other infection
- affects the torso, arms and legs first (usually), then spreads to the ears, face, scalp and groin
- does not usually affect the nails as in other forms of psoriasis
There is a suspicion that a predisposition to develop guttate psoriasis is inherited as a family history of psoriasis appears to increase the likelihood of having the skin disease. The cause of guttate psoriasis is thought to be an abnormal immune system reaction following an infection such as streptococcus (found in around 80% of guttate psoriasis sufferers). The exact nature of this connection is unknown but it does appear to involve high levels of inflammation in the skin due to elevated T cell activity after infection. This leads to the excessive creation of new skin cells, creating the familiar scales of guttate and plaque psoriasis.
Most patients have experienced tonsillopharyngitis two to three weeks before the psoriasis appears. Viruses like rubella, chickenpox and roseola have also been implicated in triggering guttate psoriasis.
Guttate psoriasis diagnosis
A diagnosis of guttate psoriasis is usually confirmed after a skin examination by a dermatologist or by a doctor who, if in doubt, may wish to perform a skin biopsy for testing (this is usually unnecessary for diagnosis). Blood tests or previous medical history can confirm an earlier infection with streptococcus or other organism and around half of all patients have increased levels of certain antibodies present in their blood.
Many cases of guttate psoriasis are relatively short-lived, lasting a few weeks to a few months, and are uncomfortable but do not significantly impact the sufferer’s quality of life. For others, guttate psoriasis may progress into chronic plaque psoriasis and/or the itchiness of the skin can lead to scratching, infection and scarring. Most guttate psoriasis treatments address the pruritis alone as the skin condition is expected to run its course and relieve within a few months at most. Some cases recur in strep carriers, with periods of remission where the skin reverts to normal.
Physicians will often take a throat culture or blood test when assessing a patient with a history or psoriasis so as to determine if there is an infection such as strep throat that is likely the cause of the the symptoms. Immediate antibiotic treatment is then very helpful in clearing the infection quickly and to relieve guttate psoriasis, with natural remedies for guttate psoriasis also available to support the healing process.
Choosing Treatments for Guttate Psoriasis
The appropriate treatment for guttate psoriasis depends largely on the patient themselves as different degrees of comfort and the severity of the condition will influence choices. Simple use of home remedies such as moisturisers may be all that is required, along with time as the body’s immune system returns to normal.