What are the characteristic features of Guttate Psoriasis and how should it be m

Characteristic Features of Guttate Psoriasis

Guttate psoriasis typically presents as multiple small, drop-shaped, erythematous, scaly papules or plaques scattered mainly on the trunk and proximal limbs. It often occurs suddenly and may be triggered by an infection, particularly a recent upper respiratory tract infection such as streptococcal pharyngitis. The condition is usually self-limiting and tends to resolve within 3 to 4 months of onset. It is important to reassure patients that guttate psoriasis is not infectious.

Management of Guttate Psoriasis

Management primarily involves reassurance and providing information and support to patients. For mild cases where lesions are not widespread or distressing, no treatment may be necessary. When treatment is desired or lesions are more extensive, topical therapies similar to those used in plaque psoriasis can be offered, including emollients to reduce scaling and topical corticosteroids or vitamin D analogues, tailored to patient preference, site, and extent of disease. Phototherapy with narrowband UVB may be considered if lesions are widespread (for example, affecting more than 10% of body surface area) or if topical treatments are insufficient.

Importantly, antibiotics should not be used to treat guttate psoriasis even if it was triggered by a streptococcal infection, as there is insufficient evidence of benefit and the condition is not infectious. Psychological assessment and support should be offered to address any associated stress, anxiety, or depression.

Patients should be reviewed approximately four weeks after starting treatment to assess response, adherence, and any adverse effects, with adjustment of management as needed. Referral to dermatology is indicated if lesions are extensive, severe, resistant to topical treatment, or if there is significant impact on wellbeing.

References: ¹