Guttate Psoriasis: Causes, Diagnosis & Treatments
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Guttate Psoriasis

What is guttate psoriasis?

Highlights

  1. Guttate psoriasis is the second most common form and affects about 10% of people with psoriasis.
  2. It causes small, red, droplet-shaped spots. The spots may have a covering of thin, flaky skin.
  3. Triggers include injury to the skin, strep throat, stress, tonsillitis, and certain medications.

Guttate psoriasis is a skin condition in which small, droplet-shaped, red patches appear on the: 

  • arms
  • legs
  • scalp
  • trunk

“Guttate” stems from the Latin word for “drop.” It’s the second most common form of psoriasis, which is an inflammatory skin condition that causes redness and irritation. It typically affects children and adults under 30 years old. Respiratory illnesses or viral infections are common triggers. According to the National Psoriasis Foundation (NPF), about 10 percent of people who have psoriasis will develop this type of psoriasis.

Unlike plaque psoriasis, which has raised lesions, the spots caused by guttate psoriasis aren’t very thick. Spots are typically small, and they may have a covering of thin, flaky skin called “scales.” 

Guttate psoriasis isn’t contagious. It can’t spread to others through contact. Spots often clear up with minor treatment. Guttate psoriasis may be a lifelong condition for some, or it may appear later as plaque psoriasis.

What are the symptoms of guttate psoriasis?

Symptoms

Guttate psoriasis attacks are often sudden. The breakouts typically involve small, red marks that intensify and expand. They can cover large portions of the body or may remain in smaller patches. 

According to the Mayo Clinic, the lesions of guttate psoriasis typically appear: 

  • small in size
  • red or dark pink
  • separate from each other
  • on the trunk or limbs
  • thinner than plaque psoriasis lesions

What causes guttate psoriasis?

Causes

The real cause of psoriasis is unknown, but research indicates that it’s an autoimmune disorder. This means that the body’s natural defense system attacks healthy cells. In psoriasis, the immune system targets the skin, which results in a rapid growth of skin cells. This causes the redness and flaky skin typical of psoriasis.

According to the NPF, certain factors may trigger an outbreak of guttate psoriasis, such as:

  • an injury to the skin
  • strep throat
  • stress
  • tonsillitis
  • certain medications, including antimalarial drugs and beta-blockers (drugs used to treat heart disorders)

How is guttate psoriasis diagnosed?

Diagnosis

Your doctor can identify signs of guttate psoriasis during a physical examination. Your regular doctor will typically refer you to a dermatologist for a proper diagnosis.

Your dermatologist will examine your skin and make note of the affected areas. This mapping will help them track treatments after diagnosis. They’ll also take a complete medical history to rule out other conditions, such as an allergic reaction. 

Your dermatologist may also order a skin biopsy to eliminate other possible contributors to the skin lesions and to help determine the type of psoriasis.

What are the treatment options for guttate psoriasis?

Treatment

A topical cream or ointment is the first line of treatment for this type of psoriasis. These often contain mild steroids. You should apply these once or twice per day. The steroids suppress the body’s immune response, resulting in fewer excess skin cells.

Other psoriasis medications include: 

  • corticosteroids, including steroid hormones similar to those produced by the adrenal glands
  • cyclosporine, which is typically used to prevent the body from rejecting a transplanted organ but is also used in other immune-related conditions
  • methotrexate, which suppresses the immune system and is typically used in severe cases or when other treatments don’t work

Besides medication, there are other therapies and strategies that can help control symptoms, such as:

  • dandruff shampoos for scalp psoriasis
  • lotions that contain coal tar, which can reduce inflammation and itching
  • cortisone cream to control itching
  • exposure to UV rays, either through sunlight or phototherapy 

Your dermatologist will help you choose the form of therapy that best suits your condition and lifestyle.

What is the long-term outlook?

Outlook

There’s no cure for psoriasis. The goal is to manage symptoms. Follow your doctor’s treatment plan, and avoid triggers when possible. The following can all trigger an outbreak: 

  • infections
  • stress
  • skin injuries
  • tobacco

If you’re using topical treatments, including them in your post-shower routine is the easiest way to remember to use them. Water strips your body of its natural moisture. Applying ointments immediately after the shower can help lock in precious moisture.

Learning more about your condition can help you manage and treat your symptoms. Consider joining a psoriasis support group and speaking to others with your condition. The knowledge and tips you gain in dealing with your condition can be invaluable.

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