Guttate Psoriasis

Written by Brian Krans | Published on August 30, 2012
Medically Reviewed by George Krucik, MD

What Is Guttate Psoriasis?

Guttate psoriasis is a skin condition in which small, droplet-shaped, red patches appear on the arms, legs, scalp, and trunk. “Guttate” stems from the Latin word for “drop.” It is the second most common form of psoriasis, an inflammatory skin condition that causes redness and irritation. It typically affects children and adults under 30, and is often triggered by respiratory illnesses or viral infections. According to the National Psoriasis Foundation (NPF), about 10 percent of people who have psoriasis will develop this type of psoriasis (NPF).

Unlike plaque psoriasis, which is characterized by raised lesions, the spots caused by guttate psoriasis are not very thick. Spots are typically small, and may or may not be covered with thin, flaky skin (scales).

Guttate psoriasis is not contagious, meaning it cannot be spread to others through contact. Spots often clear up with minor treatment. However, for some it may be a lifelong condition, or may appear later as plaque psoriasis.

What Causes Guttate Psoriasis?

The real cause of psoriasis is unknown, but research indicates that it is an autoimmune disorder, meaning 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 National Psoriasis Foundation, certain factors may trigger an outbreak of guttate psoriasis, such as:

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

Recognizing Guttate Psoriasis

Guttate psoriasis attacks are often sudden. The breakouts typically occur with small red marks that intensify and expand. They can cover large portions of the body or may be contained to 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 (Mayo Clinic, 2011)

How Is Guttate Psoriasis Diagnosed?

Signs of guttate psoriasis may be observed during a physical examination. Your regular doctor will typically refer you to a dermatologist for a proper diagnosis.

A dermatologist will examine your skin and mark down which areas are affected. This mapping will help them track treatments after diagnosis. A dermatologist will also take a complete medical history to rule out other conditions, such as an allergic reaction.

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

Treating Guttate Psoriasis

Topical creams or ointments are the first line of treatment against this type of psoriasis. These often contain mild steroids and should be applied once or twice a day. The steroids suppress the body’s immune response so fewer excess skin cells are produced.

Other psoriasis medications include:

  • corticosteroids: these include steroid hormones similar to those produced by the adrenal glands.
  • cyclosporine: this drug is typically used to prevent the body from rejected a transplanted organ, but they are used in other immune-related conditions as well.
  • methotrexate: this drug suppresses the immune system and is typically reserved for severe cases or when other treatments do not 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.

Living With Guttate Psoriasis

As there is no cure for psoriasis, the goal is to manage symptoms. This can be done by following your doctor’s treatment plan and avoiding triggers when possible. Infections, stress, skin injuries, and tobacco can all trigger an outbreak.

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

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