Guttate Psoriasis

Guttate psoriasis is also known as tear drop or rain drop psoriasis (the word was derived from the Latin, “Guttae”, which means drops). It tends to occur in children, adolescents and younger adults, and is a generalised rash of small spots up to 1 centimetre in diameter. It tends to follow an infection, often of the throat, when a bacterium called Streptococcus is the cause and appears very suddenly a week after the infection. It is wide spread but does spare the palms and soles, and clears up after several weeks or months depending on how quickly treatment is started, it may return if you suffer from the same type of sore throat again. Up to 50% of people affected will not have a further attack, but it may become chronic or evolve into one of the other types of psoriasis.
Your doctor may advise you to see him or her whenever you have a sore throat, so that you can be treated with antibiotics. This may stop the psoriasis from developing.

What is the best treatment for guttate psoriasis?
Emollients and coal tar creams are the first treatments of choice, although topical steroids and vitamin D analogues may also be prescribed. If the guttate psoriasis does not respond to these treatments, then ultraviolet light (UVB) therapy is useful.

How do I get UVB therapy?
Ultraviolet light therapy is controlled by a dermatologist in order for you to get the correct dosage for your skin type. To see a dermatologist you will require a referral letter from your GP.
UV therapy is normally given 2 or 3 times a week for 6 to 8 weeks at a time – this usually takes place in the dermatology department at your hospital, or in larger health centres. The levels and dose of UV prescribed for you by a dermatologist is carefully calculated and is much more precise and a different wavelength to the UV light emitted from a sunbed.

As guttate psoriasis can follow a streptococcal throat infection, should you have your tonsils removed?
Psoriasis on its own is not a reason to have your tonsils taken out. If you are experiencing repeated bouts of tonsillitis your doctor may recommend that you have your tonsils removed, but tonsillectomy is not generally performed in order to prevent future episodes of guttate psoriasis.