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Psoriasis - guttate

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Illustrations

Psoriasis, guttate on the arms and chest
Psoriasis, guttate on the arms and chest
Psoriasis, guttate on the cheek
Psoriasis, guttate on the cheek

Alternative names    Return to top

Guttate psoriasis

Definition    Return to top

A form of psoriasis with characteristic water drop shaped scaly macules.

Causes, incidence, and risk factors    Return to top

Guttate psoriasis is a relatively uncommon form of psoriasis. It is usually seen in patients younger than 30. Flares generally follow an infection, most notably Strep throat.

Psoriasis seems to be an inherited disorder, and it appears to be related to the immune or inflammatory response. It often is aggravated by injury or irritation (cuts, burns, rash, insect bites), and may be severe in immunosuppressed people (such as those who have chemotherapy for cancer, or with AIDS) or in people who have autoimmune disorders (such as rheumatoid arthritis). Medications, viral or bacterial infections, excessive alcohol consumption, obesity, lack of sunlight, overexposure to sunlight (sunburn), stress, cold climate, and frequent friction on the skin are also associated with flare-ups of psoriasis. The disorder is not contagious.

Normally, skin takes about a month for its new cells to move from the lower layers to the surface. In psoriasis, this process takes only a few days, resulting in the build-up of dead skin cells and formation of thick scales.

Symptoms    Return to top

Signs and tests    Return to top

Diagnosis is usually based on the appearance of the skin. There is often a history of recent sore throat. Your physician may choose to perform a skin biopsy or throat culture to help confirm the diagnosis.

Treatment    Return to top

Treatment is focused on control of the symptoms and prevention of secondary infections. It varies with the extent and severity of the disorder.

If an infection can be identified, it should be treated with appropriate antibiotics.

Severe or resistant cases, or cases involving large areas of the body, may require intensive treatment or hospitalization. Mild cases are usually treated at home. Topical medications include:

Oral or injected immunosuppressive medications (such as corticosteroids or methotrexate) may be used, but only in very severe cases. Other medications may include retinoids or cyclosporine.

Other treatments may include exposure to sunlight or phototherapy. The skin is sensitized by applying coal tar ointment or by taking oral psoralens (a medication that makes the skin sensitive to light). The person is then exposed to ultraviolet light.

To minimize flare-ups, maintain good general health. Avoid respiratory and other infections.

Expectations (prognosis)    Return to top

Psoriasis is not curable, but it can be controlled with treatment.

Complications    Return to top

Calling your health care provider    Return to top

Call for an appointment with your health care provider if symptoms indicate guttate psoriasis.

Update Date: 8/15/2003

Updated by: Michael Lehrer, M.D., Department of Dermatology, University of Pennsylvania Medical Center, Philadelphia, PA. Review provided by VeriMed Healthcare Network.

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