Guttate psoriasis is a subtype of psoriasis. It appears primarily in children and young adults.
What is guttate psoriasis?
In medicine, guttate psoriasis is also known as exanthematous psoriasis. It represents one of several different sub-forms of psoriasis (psoriasis). Around two percent of all patients suffering from psoriasis are affected by guttate psoriasis.
This special variant of psoriasis is mainly found in children and young adults. Psoriasis is relatively widespread in Germany. Around two percent of all Germans have a specific form of psoriasis. In most cases, guttate psoriasis is the result of throat infections. See whicheverhealth for PLS Meanings.
Following this infection, small red dots appear on different parts of the body. In contrast to common psoriasis (psoriasis vulgaris), which makes up the largest proportion of psoriasis at around 90 percent, the affected areas are rather small and are lens or drop-shaped. In addition, guttate psoriasis appears predominantly on the trunk of the body.
In most cases, guttate psoriasis is triggered by bacterial infections in the pharynx. These include pharyngitis (inflammation of the throat), rhinopharyngitis (combined inflammation of the throat and nasal mucosa) and tonsillitis (tonsillitis). Scarlet fever is also a possible trigger. Bacteria such as streptococci are responsible for the diseases.
About one to two weeks after the onset of the bacterial infection, guttate psoriasis finally appears. Another possible trigger for the sub-form of psoriasis is the intake of certain drugs such as chloroquine, hydroxylchloroquine, lithium and beta blockers.
If psoriasis symptoms appear after administration of these agents, it is recommended to stop them immediately, but this should be discussed with a doctor beforehand. However, it is also possible that guttate psoriasis breaks out without these special factors or is simply the precursor to another psoriasis disease.
Symptoms, Ailments & Signs
Typical symptoms appear in the context of guttate psoriasis. Small, round foci with a reddish color spread over certain parts of the body or even the entire body. However, the color, extent and shape of the dots may present differently from patient to patient. Their size varies between a lens, a pinhead or a dime.
In most patients, guttate psoriasis begins very suddenly and affects the face, back and chest. Between 60 and 80 percent of all affected people also suffer from itching. In some cases, this can be very pronounced. The patient’s scalp is particularly affected.
Despite severe itching, doctors advise against rubbing and scratching the affected areas of skin. Otherwise there is a risk that wounds will form in these areas, which will then become infected. Another possible symptom of guttate psoriasis is a temporary decrease or increase in skin pigmentation. Quite a few patients also suffer from psychological problems because they feel disfigured by the disease.
In the worst case, this leads to prolonged depressive moods. If the disease occurs on visible parts of the body such as the face or neck, some people tend to withdraw more and more from their fellow human beings and eventually isolate themselves. Excessive stress is also considered an unfavorable factor. This can have a negative effect and cause fresh flare-ups, which means that guttate psoriasis spreads more quickly after severe mental stress.
Diagnosis & course of disease
Diagnosing guttate psoriasis is not difficult. An experienced doctor usually recognizes the disease by its typical symptoms on the skin. Guttate psoriasis can be distinguished from psoriasis vulgaris by small punctiform spots, while thick plaques occur in common psoriasis.
The course of this variant of psoriasis cannot always be determined in advance. The disease manifests itself differently from patient to patient. It is not uncommon for it to expand further and turn into psoriasis vulgaris. However, it is possible to prevent this by treating the disease triggers.
Occasionally, guttate psoriasis can heal on its own and eventually disappear. Doctors then speak of spontaneous healing, which, however, only occurs in rare cases.
Due to guttate psoriasis, those affected suffer from psoriasis in most cases. As a rule, the patients are ashamed of this complaint, so that it is not uncommon for those affected to have reduced self-esteem or inferiority complexes. Depression or other psychological upsets can also occur and limit the patient’s quality of life.
Children can also suffer from bullying or teasing at a young age. The skin of those affected turns reddish due to the disease and small dots form on the skin. Furthermore, the skin is affected by itching, which is only intensified by scratching. Excessive scratching can also cause scars.
Furthermore, the symptoms of guttate psoriasis are significantly increased by stress and inner restlessness. The treatment of guttate psoriasis usually depends on the underlying disease. Some skin areas may need to be treated with the help of different therapies. There are no complications. Guttate psoriasis does not negatively affect the life expectancy of the patient.
When should you go to the doctor?
Guttate psoriasis should always be treated by a doctor. Self-healing does not occur and in most cases the disease cannot be cured by self-help. In order to avoid further complications, a doctor should always be consulted for guttate psoriasis. The doctor should be consulted if there is slight redness all over the body. This redness appears for no particular reason and will not go away on its own. It is not uncommon for severe itching to indicate guttate psoriasis and should be examined by a doctor. Usually a dermatologist can be consulted.
Since guttate psoriasis can also lead to psychological symptoms or depression, a psychologist should be consulted in addition to treating the skin to alleviate the psychological symptoms.
Treatment & Therapy
Guttate psoriasis can be completely cured if the triggering cause is treated. It may be necessary to take action against tonsillitis or pharyngitis. Otherwise, the therapy is similar to the treatment of psoriasis vulgaris. This can be remedied by the use of moisturizing creams or ointments.
However, it is often time-consuming to carry out an external treatment of the many small skin areas. Phototherapy (light therapy) or PUVA therapy, which is a mixture of phototherapy and medication, is often used for this reason. Drugs in the form of injections or tablets are used in severe cases. The doctor usually administers ciclosporin, methotrexate, retinoids or corticoids.
Direct prevention of guttate psoriasis is not possible. However, if there is a hereditary predisposition to psoriasis, it makes sense to reduce your alcohol and nicotine consumption. In principle, the outbreak of guttate psoriasis is also possible if the person eats healthily or does sports, because bacterial infections of the throat cannot always be prevented.
The daily basic therapy of guttate psoriasis helps to restore the intact skin barrier. This includes the external application of active substance-free ointment bases on the skin. The external application of salicylic acid and ointments with three to ten percent urea can regenerate the skin. The therapy can be supported by oil and brine baths.
Another proven remedy is coal tar, which is applied to the local area as an ointment or gel. It soaks in there for a few hours and is then washed off. Sometimes it has to be a strong drug like cortisone. It is important that the skin is supplied with moisture on a daily basis. Natural home remedies such as almond oil, grape seed oil or compresses made from healing earth are suitable for this.
As a rule, basic therapy alone is not sufficient aftercare for guttate psoriasis. Many patients suffer from psoriasis from an enormous psychological strain. Of course, stress can also interact and aggravate guttate psoriasis.
Psychosomatic treatment and patient training can therefore be very useful. The patient receives important information about the clinical picture and learns what to look out for when caring for the skin. Information about ways to reduce stress and relaxation methods is very helpful. Such training can be outpatient or inpatient.
You can do that yourself
Guttate psoriasis can be treated by those affected themselves. All that is necessary for this is comprehensive preparation by the doctor, who prescribes the necessary ointments and gives tips for use.
The consistent treatment of psoriasis by means of strict personal hygiene and soothing ointments is important. The bed linen should be changed several times a week and the living areas should be cleaned of any dust and dirt. Cooling pads and baths with herbal additives help against the itching. It is essential to avoid scratching the skin changes, as this can lead to further pain or even scarring. In addition, the diet must alsobe switched. A healthy and balanced diet, which should consist of lots of fruit and vegetables, is recommended. Unhealthy foods such as fast food, sugar or fatty foods should be avoided. Guttate psoriasis patients should also avoid alcohol and cigarettes.
In addition to symptomatic treatment, the causes of guttate psoriasis must be identified and eliminated. This is achieved by consistently observing and ruling out possible triggers. Avoiding certain medications or changing jobs helps many of those affected.