- Stephanie Mehlis, MD
Stephanie Mehlis, MD
- Clinical Instructor, Division of Dermatology
- University of Chicago, Pritzker School of Medicine
Psoriasis is a common skin disorder characterized by the development of inflammatory plaques on the skin. The spectrum of clinical manifestations of psoriasis is wide, and includes chronic plaque, guttate, inverse, erythrodermic, pustular, and nail variants of the disease. (See "Epidemiology, clinical manifestations, and diagnosis of psoriasis", section on 'Clinical manifestations'.)
Patients with guttate psoriasis typically present with the acute onset of numerous small, inflammatory, scaly plaques on the trunk and extremities (picture 1A-B). Guttate psoriasis is most common among children and young adults, and a preceding history of streptococcal infection is often present.
The epidemiology, clinical manifestations, and treatment of guttate psoriasis will be reviewed here. Other manifestations of psoriasis are discussed separately. (See "Epidemiology, clinical manifestations, and diagnosis of psoriasis" and "Treatment of psoriasis".)
Psoriasis occurs in 0.6 to 4.8 percent of the general population , with chronic plaque psoriasis as the most common clinical presentation. Estimates of the proportion of patients with psoriasis who develop guttate disease vary widely; many studies cite a prevalence of less than 30 percent among patients with psoriasis [2-6].
Guttate psoriasis is most frequently diagnosed in children and young adults under the age of 30; however, older individuals may also be affected [7-9]. As an example, in a Spanish study that compared 1092 patients in whom psoriasis began between the ages of 0 and 30 years to 662 patients with disease onset later in life, patients in the younger-onset group were significantly more likely to have the guttate variant (15 versus 7 percent) .
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- RISK FACTORS
- Streptococcal infection
- Other infections
- CLINICAL MANIFESTATIONS
- Laboratory tests
- Differential diagnosis
- CLINICAL COURSE
- First-line therapies
- - Phototherapy
- - Topical corticosteroids and vitamin D analogs
- Refractory disease
- - Tonsillectomy
- - Systemic psoriasis therapies
- Other interventions
- - Systemic antibiotics
- SUMMARY AND RECOMMENDATIONS