Psoriasis—a chronic, inflammatory skin condition—affects more than eight million people in the U.S. alone. From there, things get a little trickier. There are actually five different types of psoriasis, according to the National Psoriasis Foundation (NPF): plaque, guttate, inverse, pustular, and erythrodermic.
Of all the five types, guttate psoriasis is a bit less common than others. "While psoriasis affects between two to four percent of the population, guttate psoriasis comprises only a small percentage of those patients," says says Bobbak Mansouri, MD, a board-certified dermatologist in Tyler, Texas.
In addition to its rarity, guttate psoriasis is considered a "reactive psoriasis," says Erum Ilyas, MD, a board certified dermatologist in King of Prussia, Pennsylvania. That means “it’s often triggered by an immune system reaction to a viral or bacterial infection," she says. Here's everything else you need to know about guttate psoriasis, and the treatment options available.
Okay, what exactly is guttate psoriasis?
Guttate psoriasis—a form of psoriasis that appears as small, dot-like lesions—is actually named for its unique rash. (The word "guttate" in Latin literally means "drops.") This type of psoriasis manifests in small, salmon-pink patches that take the shape of raindrops and can erupt suddenly (again, typically after an infection like strep throat) on the trunk of your body, but not your nails, palms, or the soles of your feet, where psoriasis typically appears, says Dr. Mansouri.
Unlike other forms of psoriasis, guttate psoriasis is typically seen in children and young adults. Another difference: The spots aren’t as solid as the ones from plaque psoriasis (they typically have a scaly, white appearance), and just because you develop guttate psoriasis once doesn’t necessarily mean you will cope with psoriasis over the long-term. "Many patients with guttate psoriasis will never deal with another breakout of psoriasis once their guttate psoriasis has resolved," says Dr. Mansouri. “Others will have flare-ups every now and then."
So how is guttate psoriasis treated?
With guttate psoriasis in particular, the first step to finding a treatment that works is identifying the underlying infection that triggered the guttate psoriasis, says Dr. Ilyas. From there, treatment for that infection, as well as over-the-counter or prescription medications in topical form are the first line in addressing the itchy skin and swelling. "We usually treat guttate psoriasis with topical steroids and/or nonsteroidal creams," she says.
While a one-time treatment usually clears the condition, some people who develop guttate psoriasis do go on to develop chronic plaque psoriasis that resembles guttate psoriasis, Dr. Mansouri adds. If that’s the case, you may need to begin taking oral medication. “This entity is termed by some as ‘small plaque psoriasis’ and is considered a chronic form of psoriasis,” he says. “That’s why chronic forms of psoriasis that have guttate lesions are treated similarly to other chronic forms of psoriasis.”
Still, for more serious cases, your dermatologist may also recommend light therapy directly to the affected skin. “Light therapy for psoriasis has been around for decades as it has been shown to help treat psoriasis by reducing certain inflammatory cells in the skin," Dr. Ilyas previously told Health. ” While this therapy can be effective, the downside is that you may be required to undergo two to three treatments a week at your doctor’s office over the course of several weeks, she says.
Biologic injections are another option, and are essentially a treatment that works by altering the immune system to control psoriasis from the inside out—which can be helpful if the psoriasis is more widespread.
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