Guttate psoriasis triggered by perianal streptococcal dermatitis in a four-year-old boy

J Am Acad Dermatol. 2000 May;42(5 Pt 2):885-7. doi: 10.1016/s0190-9622(00)90263-9.

Abstract

Perianal streptococcal dermatitis (PSD) is a superficial bacterial infection usually with group A beta-hemolytic streptococci. PSD is often misdiagnosed for long periods and patients are subjected to treatments for a variety of differential diagnoses without success. We report a 4-year-old boy with PSD who presented to our clinic with guttate psoriasis for 2 reasons: first, to make dermatologists aware of PSD and second, to emphasize the necessity to examine patients, particularly pediatric patients, with guttate psoriasis very thoroughly and swab both the pharynx and perianal and/or perigenital areas even when they are, or seem to be, asymptomatic for bacterial infections. Once PSD has been diagnosed, systemic antibiotic therapy with penicillin, erythromycin, roxithromycin, or azithromycin (probably augmented by topical mupirocin ointment) should be the treatment of choice. Therapy should be monitored by posttreatment perianal and throat swabs as well as a urine analysis to monitor for poststreptococcal glomerulonephritis.

Publication types

  • Case Reports

MeSH terms

  • Anal Canal / microbiology
  • Anal Canal / pathology
  • Anti-Bacterial Agents / therapeutic use
  • Child, Preschool
  • Dermatitis / complications*
  • Dermatitis / drug therapy
  • Dermatitis / microbiology
  • Diagnosis, Differential
  • Humans
  • Male
  • Perineum / microbiology
  • Perineum / pathology
  • Psoriasis / etiology*
  • Psoriasis / pathology
  • Skin Diseases, Bacterial / complications*
  • Skin Diseases, Bacterial / drug therapy
  • Skin Diseases, Bacterial / microbiology
  • Streptococcal Infections / complications*
  • Streptococcal Infections / drug therapy
  • Streptococcal Infections / microbiology

Substances

  • Anti-Bacterial Agents