Guttate psoriasis is characterized by the acute onset of small, 1-10 mm diameter, droplike, erythematous-to-salmon-pink papules, usually with a fine scale, as demonstrated in the images below. Streptococcus pyogenes) often precedes the eruption by 2-3 weeks. Proteomic and immunohistochemistry studies have demonstrated that guttate psoriasis and chronic plaque psoriasis are phenotypically distinguishable in their protein expression patterns. Psoriasis is a long-lasting autoimmune disease characterized by patches of abnormal skin. Psoriasis vulgaris (also known as chronic stationary psoriasis or plaque-like psoriasis) is the most common form and affects 85 90 of people with psoriasis. This form of psoriasis is characterized by an acute onset of numerous pustules on top of tender red skin. Skin from a biopsy will show clubbed epidermal projections that interdigitate with dermis on microscopy. In the USA, approximately 2 of the population is affected. The mean age of onset for the first presentation of psoriasis can range from 15 to 20 years of age, with a second peak occurring at 55 60 years. Psoriasis can be highly variable in morphology, distribution, and severity. In children, an acute episode of guttate psoriasis is usually self limiting; in adults, guttate flares may complicate chronic plaque disease.
Psoriasis shows a worldwide prevalence. Morphology of the lesions, b. degree of inflammation, c. distributing patterns of the lesions, d. There are two distinct morphological subtypes of plaque psoriasis: Rupioid and Ostraceous. This variety is distinguished by its acute onset of round erythematous exanthem (2-10 mm diameter) over the trunk and extremities in a centripetal fashion. Guttate psoriasis typically presents as an acute bilateral, symmetric eruption consisting of multiple, well-demarcated, salmon-pink to erythematous, round to oval papules ranging in size from 1 mm to 10 mm in diameter. Pityriasis rosea can be differentiated from guttate psoriasis on the basis of morphology and arrangement. This study confirms the strong link between onset of guttate psoriasis phenotype and streptococcal throat infection, whereas onset of plaque psoriasis was highly associated with a preceding distinct stressful life event.
The eczematous reaction pattern of skin includes the gamut of diseases called eczema or dermatitis. The typical morphology is a 1-cm or larger well-demarcated red plaque surmounted by white or silvery scales. In a recent study of new onset psoriasis, acute streptococcal pharyngitis was verified in 63 of cases (3). Arthritis occurs after the onset of skin disease in 2/3 of cases. Acute streptococcal infection precipitates guttate psoriasis. 3-1 and 3-2); scales may not be visible but become apparent upon scraping. The lesions show less erythema than in Caucasian skin. FIGURE 3-2 Psoriasis vulgaris: buttocks (guttate type) Discrete, erythematous, scaling, small papules that tend to coalesce, appearing after a group A streptococcal pharyngitis. Serology Increased antistreptolysin titer in acute guttate psoriasis with antecedent strepto- coccal infection.
Clinical Presentation Of Psoriasis
CONCLUSION: Patients with early and late onset psoriasis often show different clinical and evolutionary features. Cases were patients with a first diagnosis ever of acute guttate psoriasis, made by a dermatologist. Our purpose was to study the morphology and pattern of lesions in Indian patients with palmoplantar psoriasis and to elucidate the role of occupation in the incidence/localization of these lesions. The patient experienced a distinct change in the morphology of his existing psoriatic plaques, which became ulcerated and necrotic in the week following the methotrexate injection. Two patterns of skin ulceration induced by methotrexate in patients with psoriasis. This is part I of a two-part article on generalized rashes. Sweet syndrome (i.e., acute febrile neutrophilic dermatosis). Erythema; edema; vesicles; bullae in linear or geometric pattern; common causes include cosmetics, topical medications, metal, latex, poison ivy, textiles, dyes, sunscreens, cement, food, benzocaine, neomycin13; keys to diagnosis are linear or geometric pattern and distribution of lesions. Psoriasis (plaque psoriasis). Sudden onset of high fever without rash or other symptoms in a child younger than 3 years; as fever subsides, pink, discrete, 2- to 3-mm blanching macules and papules suddenly appear on trunk and spread to neck and extremities; key to diagnosis is high fever followed by sudden appearance of rash as fever abruptly resolves23. Overall morphology and distribution of the rash. These are sites of friction and do not show the typical silvery scale. It can be used on stable chronic plaque psoriasis but will irritate acute, inflamed skin. The pattern on the skin resembles a dry river-bed or ‘crazy-paving’. Diagnose atopic eczema when a child has an itchy sin condition plus three or more of the following: – visible flexural dermatitis involving the skin creases (or visible dermatitis on the cheeks and/or extensor areas in children aged 18 months or under) – personal hx of flexural dermatitis – personal history of dry skin in the last 12 months – personal hx of asthma or allergic rhinitis (or history of atopic disease in a first-degree relative of children aged under 4 years) – onset of signs and symptoms under the age of 2 years. Up to 30 of these patients manifest by age 2 with psoriatic diaper rash. Precipitating factors are more common in childhood compared with adult-onset psoriasis. Psoriasis arising during the acute and convalescent phases of Kawasaki disease has been reported in infants as young as 3 months. Psoriasis in infants offers unique variations of morphology and distribution.