What Is Guttate Psoriasis?

Reviewed by: HU Medical Review Board | Last reviewed: July 2016.

Plaque psoriasis is by far the most common form of the disease. There are several other less common forms of psoriasis, however. Guttate psoriasis is the second most common type. It is related to plaque psoriasis, but people with guttate psoriasis develop different types of plaques and the condition’s most common triggers are different. For example, it commonly occurs after a person has had an infection, such as strep throat.

What are the symptoms of guttate psoriasis?

The symptoms of guttate psoriasis are small plaques that are shaped like little teardrops or raindrops and are often pink in color. These plaques are also called “lesions.” When the guttate psoriasis plaques first appear, they are not usually scaly, but this can happen later on1.

Guttate psoriasis plaques can appear anywhere on the body. They often appear in the following places:2

  • trunk (including the chest, stomach, and back)
  • upper arms
  • thighs
  • face
  • ears
  • scalp

These lesions may often appear very quickly over a few days. Some people may only have a few lesions, while others will have many lesions in different areas3. The lesions can sometimes be itchy, but not always.

What causes guttate psoriasis?

Guttate psoriasis can often be triggered by having an infection. The most common type of infection that can trigger an outbreak is strep throat, which is an upper respiratory infection caused by bacteria called “streptococcus.2” The guttate psoriasis symptoms may not appear until a couple of weeks after the person has had the infection.

Although strep infections are the most common trigger, other types of infections can also trigger outbreaks of guttate psoriasis, including fungal infections, such as candida. Viral infections can sometimes be triggers as well, such as human papillomavirus (HPV), varicella-zoster virus, and retroviruses3.

Taking certain types of medications can also sometimes trigger guttate psoriasis. These include:

  • lithium
  • beta-blockers
  • anti-malaria drugs
  • nonsteroidal anti-inflammatory medicines: common painkillers such as aspirin or ibuprofen

How common is guttate psoriasis?

Around 10%-20% of people with psoriasis worldwide have guttate psoriasis1. It more commonly affects children and younger adults under the age of 30. Guttate psoriasis is less common among people in the United States than among people in other countries. Research suggests that only around 2% of people with psoriasis in the United States have guttate psoriasis2.

How is guttate psoriasis treated?

For many people, a flare-up of guttate psoriasis will clear up after a few weeks or months without any treatment at all. Other people may need one or more types of treatment for their symptoms.

Common types of treatments for guttate psoriasis include:

Over-the-counter topical treatments such as special emollient lotions to help moisturize the skin. Coal tar is a topical treatment that works by suppressing the production of excess skin cells that cause the plaques3. Some people may need to use stronger medicines called topical corticosteroids in order to help treat more severe symptoms. If a person’s guttate psoriasis has been triggered by an infection, then healthcare providers may recommend taking a course of antibiotics to treat that infection. Other people may be advised to try prescription medicines made from Vitamin D or Vitamin A.

Phototherapy is another treatment option sometimes used for guttate psoriasis4. Some people’s symptoms respond well to natural sunlight exposure or to phototherapy delivered through a special machine at the clinic or home. For either type of treatment, it is important to follow your healthcare providers’ instructions carefully, because too much sunlight or phototherapy can sometimes make symptoms worse.

People with more severe guttate psoriasis may need treatment with stronger medicines, such as systemic or biologic medicines, which work by affecting the entire body to treat symptoms.

Can guttate psoriasis be prevented or cured?

Symptoms of guttate psoriasis will often go away within a couple of months or less after they appear. The lesions rarely leave scars after they disappear. Many people will never have another outbreak, although some people will go on to have another flare up in the future3. People who have had guttate psoriasis are slightly more likely to develop plaque psoriasis later on, but many people never do.

Treating an infection like strep throat at an early stage can help to prevent a person from developing guttate psoriasis. For this reason, it is important for people with a history of psoriasis to see a healthcare provider immediately if they develop any symptoms of strep throat or other types of infection.

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