From the Guidelines
Guttate psoriasis is characterized by small, drop-shaped, salmon-pink to red spots that typically appear suddenly on the trunk, arms, legs, and scalp, often triggered by streptococcal throat infection, and can be managed with topical treatments, phototherapy, and addressing underlying triggers. The condition presents with lesions that are usually 1-10mm in diameter, have a fine scale, and often number in the dozens to hundreds 1.
Key Features of Guttate Psoriasis
- Small, drop-shaped lesions
- Salmon-pink to red spots
- Typically appears on the trunk, arms, legs, and scalp
- Often triggered by streptococcal throat infection, viral infections, stress, skin injury, and certain medications
- Lesions are usually 1-10mm in diameter and have a fine scale
- Patients may experience mild itching, and the spots can sometimes be tender
Management and Treatment
- Topical corticosteroids
- Vitamin D analogs
- Phototherapy, particularly narrowband UVB, which may be especially helpful 1
- Addressing the underlying trigger, such as antibiotics for streptococcal infection if still present, with options including phenoxymethyl penicillin or erythromycin 1
- Keeping the skin moisturized and avoiding known triggers like stress and skin trauma can help manage symptoms. In some cases, repeated attacks of guttate psoriasis after well-documented episodes of tonsillitis may be an indication for referral to an otolaryngologist for consideration of tonsillectomy 1.
From the Research
Guttate Psoriasis Signs and Symptoms
- Guttate psoriasis is a variant of psoriasis characterized by scattered "drop-like" papules and plaques, accounting for up to a quarter of psoriasis cases 2.
- The condition can clear within 3 to 4 months, but up to 39% of cases may progress to chronic plaque psoriasis 2.
Treatment Options
- Topical treatments, such as corticosteroids and calcipotriol creams, have shown efficacy in treating guttate psoriasis 2.
- Phototherapy, particularly narrowband ultraviolet B (UVB), has robust evidence for its effectiveness in treating guttate psoriasis 2, 3, 4, 5.
- Systemic therapies, including traditional immunosuppressants, antibiotics, retinoids, and biologics, may also be used to treat guttate psoriasis 2.
Phototherapy
- Narrowband UVB phototherapy is a commonly used treatment option for psoriasis, including guttate psoriasis 3, 4, 5.
- Phototherapy can be used in combination with topical treatments, such as emollients, calcipotriene, corticosteroids, retinoids, and tar 3.
- Narrowband UVB phototherapy has been shown to improve quality of life for patients with psoriasis and atopic dermatitis, with results lasting up to 3 months 6.
Patient Assessment and Satisfaction
- Patients with guttate psoriasis have reported high satisfaction with phototherapy treatment, particularly narrowband UVB 4.
- Patient assessment tools, such as the Dermatology Life Quality Index (DLQI), can be useful in evaluating the effectiveness of treatment and quality of life for patients with psoriasis and atopic dermatitis 6.