Guttate psoriasis is a subtype of psoriasis. It primarily manifests in children and young adults.
What is guttate psoriasis?
In the medical community, guttate psoriasis is also known as exanthematous psoriasis. It represents one of several different subtypes of psoriasis. Approximately two percent of all patients suffering from psoriasis are affected by guttate psoriasis. This particular variant of psoriasis is predominantly seen in children and young adults. In Germany, psoriasis is relatively widespread. Around two percent of all German citizens have a certain form of psoriasis. In most cases, psoriasis guttata is the consequence of throat infections. Following this infection, small red spots appear on different parts of the body. In contrast to ordinary psoriasis (psoriasis vulgaris), which accounts for the largest proportion of psoriasis (about 90 percent), the affected areas tend to be small and lentil- or teardrop-shaped. In addition, psoriasis guttata is predominantly seen on the trunk of the body.
Causes
Triggers of guttate psoriasis in most cases are bacterial infections of the throat. These include pharyngitis (inflammation of the throat), rhinopharyngitis (combined inflammation of the mucous membranes of the throat and nose), and tonsillitis (inflammation of the tonsils). Scarlet fever is also a possible trigger. Bacteria such as streptococci are responsible for the illnesses. About one to two weeks after the onset of the bacterial infection, the psoriasis guttata finally appears. Another possible trigger for the psoriasis subform is the use of certain medications such as chloroquine, hydroxyl chloroquine, lithium and beta blockers. If psoriasis symptoms appear after the administration of these drugs, it is recommended to discontinue them immediately, but this should be discussed with a doctor beforehand. However, it is also possible for guttate psoriasis to erupt without these specific factors or simply to be the precursor of another psoriatic condition.
Symptoms, complaints, and signs
Typical symptoms occur in the context of guttate psoriasis. Thus, small roundish foci with a reddish color spread over certain parts of the body or even the entire body. However, the color, size and shape of the spots can vary from patient to patient. Thus, their size varies between a lens, a pinhead or a penny coin. In most patients, guttate psoriasis begins very suddenly and starts on the face, back, and chest. Between 60 and 80 percent of all affected individuals also suffer from itching. This can also be severe in some cases. The patient’s scalp is particularly affected. Despite strong itching, doctors advise against rubbing and scratching the affected skin areas. Otherwise, there is a risk that sores will form on these areas, which will then become infected. Another possible symptom of guttate psoriasis is a temporary weakening 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, prolonged depressive moods occur because of this. 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. Thus, this can have a negative effect and provide for fresh episodes of the disease, whereby the psoriasis guttata spreads more rapidly after stronger mental stress.
Diagnosis and course of the disease
Diagnosing guttate psoriasis is not difficult at all. An experienced physician can usually recognize the disease by its typical symptoms on the skin. Psoriasis guttata can be distinguished from psoriasis vulgaris by small punctate spots, while thick plaques appear in common psoriasis. The course of this variant of psoriasis cannot always be predicted. Thus, the disease manifests itself differently from patient to patient. It is not uncommon for it to extend further and turn into psoriasis vulgaris. However, it is possible to prevent this by treating the triggers of the disease.Occasionally, guttate psoriasis can also heal on its own and eventually disappear. Doctors then speak of a spontaneous healing, which, however, only occurs in rare cases.
Complications
Due to guttate psoriasis, in most cases, those affected suffer from psoriasis. As a rule, the patients are ashamed of this complaint, so that it is not uncommon for a reduced self-esteem or further also inferiority complexes to occur in those affected. 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. Due to the disease, the skin of the affected person turns reddish and small dots form on the skin. Furthermore, the skin is affected by itching, which is only further intensified by scratching. Also scars can develop thereby with excessive scratching. Furthermore, the symptoms of guttate psoriasis are significantly aggravated by stress and inner turmoil. The treatment of guttate psoriasis usually depends on the underlying disease. It may be necessary to treat some skin areas with the help of different therapies. Complications do not occur. Guttate psoriasis does not negatively affect the patient’s life expectancy.
When should one go to the doctor?
The disease guttate psoriasis should always be treated by a doctor. There is no self-healing and in most cases the disease cannot be cured by means of self-help. Therefore, to avoid further complications, a doctor should always be consulted in cases of guttate psoriasis. The doctor should be consulted when there is a slight redness on the whole body. This redness occurs without any particular reason and does not disappear on its own. Not infrequently, severe itching may also indicate guttate psoriasis and should be examined by a doctor. As a rule, a dermatologist can be consulted. Since guttate psoriasis can further lead to psychological discomfort or depression, a psychologist should also be consulted in addition to the treatment of the skin to alleviate the psychological discomfort.
Treatment and therapy
Guttate psoriasis can be completely cured, provided that the triggering cause is treated. To do this, it may be necessary to treat tonsillitis or pharyngitis. Otherwise, the therapy is similar to the treatment of psoriasis vulgaris. Remedy can be achieved by the application of moisturizing creams or ointments. However, it is often costly to carry out an external treatment of the many small skin areas. For this reason, phototherapy (light therapy) or PUVA therapy, which is a mixture of phototherapy and medication, are often used. Medications in the form of injections or tablets are used in severe cases. In these cases, the doctor usually administers ciclosporin, methotrexate, retinoids or corticosteroids.
Prevention
Direct prevention of guttate psoriasis is not possible. However, if there is a hereditary predisposition to psoriasis, it is considered reasonable to reduce one’s alcohol and nicotine consumption. In principle, however, the outbreak of psoriasis guttata is possible even if a person eats a healthy diet or is active in sports, because bacterial infections of the throat cannot always be prevented.
Follow-up
Basic daily therapy for guttate psoriasis helps restore the intact skin barrier. This includes the topical application of drug-free ointment bases to the skin. External application of salicylic acid and ointments containing three to ten percent urea can also regenerate the skin. The therapy can be supported by oil and brine baths. Another proven remedy is coal tar, which is applied as an ointment or gel to the local area. It is absorbed there for a few hours and then washed off. Sometimes it must also be a strong active ingredient such as cortisone. It is important that the skin is moisturized daily. Natural home remedies such as almond oil, grape seed oil or poultices made of healing clay are suitable for this. As a rule, basic therapy is not sufficient as the sole aftercare for guttate psoriasis. Many patients suffer from enormous suffering and psychological stress as a result of psoriasis. Of course, stress can also be an interaction and aggravate the psoriasis guttata.Psychosomatic treatment and patient training can therefore be very useful. Here, the patient receives important information about the clinical picture and learns what he or she must pay attention to when caring for the skin. Information on ways to reduce stress and relaxation methods is very helpful. Such training can take place on an outpatient basis, but also on an inpatient basis.
What you can do yourself
Guttate psoriasis can be treated by those affected themselves. All that is necessary for this is comprehensive preparation by the doctor, in that he prescribes the necessary ointments and gives tips on how to use them. It is important to treat the psoriasis consistently by means of strict body hygiene and soothing ointments. The bed linen should be changed several times a week and the living rooms should be cleaned of any dust and dirt. Cooling compresses and baths with herbal additives help against itching. Scratching the skin lesions must be avoided at all costs, as this may lead to further pain or even scarring. In addition, the diet must also be changed. A healthy and balanced diet is recommended, which should consist of plenty of fruits and vegetables. Unhealthy foods such as fast food, sugar or fatty foods should be avoided. Psoriasis guttata patients should also avoid alcohol and cigarettes. In addition to symptomatic treatment, the causes of the psoriasis guttata must be determined and eliminated. This can be achieved by consistent observation and exclusion of possible triggers. Many sufferers are helped by avoiding certain medications or changing jobs.
