Psoriasis: guttate
Guttate psoriasis is more common in children and adolescents. It may be precipitated by a streptococcal infection 2-4 weeks prior to the lesions appearing
Features
Management
Differentiating guttate psoriasis and pityriasis rosea
Features
- tear drop papules on the trunk and limbs
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| © Image used on license from DermNet NZ | |
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| © Image used on license from DermNet NZ | |
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| © Image used on license from DermNet NZ | |
Management
- most cases resolve spontaneously within 2-3 months
- there is no firm evidence to support the use of antibiotics to eradicate streptococcal infection
- topical agents as per psoriasis
- UVB phototherapy
- tonsillectomy may be necessary with recurrent episodes
Differentiating guttate psoriasis and pityriasis rosea
| Guttate psoriasis | Pityriasis rosea | |
|---|---|---|
| Prodrome | Classically preceded by a streptococcal sore throat 2-4 weeks | Many patients report recent respiratory tract infections but this is not common in questions |
| Appearance | 'Tear drop', scaly papules on the trunk and limbs | Herald patch followed 1-2 weeks later by multiple erythematous, slightly raised oval lesions with a fine scale confined to the outer aspects of the lesions. May follow a characteristic distribution with the longitudinal diameters of the oval lesions running parallel to the line of Langer. This may produce a 'fir-tree' appearance |
| Treatment / natural history | Most cases resolve spontaneously within 2-3 months Topical agents as per psoriasis UVB phototherapy | Self-limiting, resolves after around 6 weeks |