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. Streptococcal perianal dermatitis, a superficial bacterial infection of the anus and perianal skin in children, has also been linked with the appearance of guttate psoriasis. Although episodes may recur, especially those due to pharyngeal carriage of streptococci, isolated bouts have commonly been described. Figure 1 Acute guttate psoriasis on arms and trunk. Although the association between streptococcal infection and AGP is perhaps the most well described,8,10 strep infection has been shown to be associated with plaque11 as well as with pustular psoriasis.4. Several researchers recommend testing for perianal and pharyngeal streptococcal infection in any child presenting with acute guttate, pustular, or plaque psoriasis and treating with oral antibiotics when cultures are positive. Guttate psoriasis is a distinctive acute skin eruption characterised by small drop-like, salmon-pink papules which usually have a fine scale. Guttate psoriasis may be chronic and unrelated to streptococcal infection. Cultures: bacterial culture of the throat or perianal area.
In contrast, the pharyngeal isolates were distributed among 6 different T and emm types. Perineal infection caused by GAS may be a relatively common diagnosis in a pediatric or family practice setting. (1988) Guttate psoriasis associated with perianal streptococcal disease. The guttate psoriasis resolved, and she was released from dermatologic care at a follow-up appointment 2 months later. Pharyngitis is an inflammation of the pharynx, tonsils and surrounding lymphoid tissue. 7,10 Infectious mononucleosis usually occurs in otherwise healthy older children and young adults7 and commonly occurs in group settings, such as educational institutions.10. 1 In 56 to 97 of patients, guttate psoriasis is associated with a preceding or concurrent streptococcal infection.1,3,4,9 The streptococcal infection can also have perianal involvement. Guttate psoriasis is frequently associated with a preceding pharyngeal or perianal streptococcal infection in children.
Judith Simms-Cendan, Kathleen Zendell. Guttate psoriasis is frequently associated with a preceding pharyngeal or perianal streptococcal infection in children. Several variants of psoriasis are seen in children, the most prevalent types include plaque, guttate, and psoriatic diaper rash; pustular and erythrodermic psoriasis are less frequently observed. ABSTRACT Several variants of psoriasis are seen in children, the most prevalent types include plaque, guttate, and psoriatic diaper rash; pustular and erythrodermic psoriasis are less frequently observed. 6 In a review of 1262 cases of psoriasis, initial disease onset occurring before the age of 2 years was found in 14-27. 2,6,8,13 Streptococcal pharyngitis and perianal streptococcal dermatitis are common causes of guttate psoriasis in children. Keywords: adolescent psoriasis, pediatric psoriasis, treatment, systemic treatment, biologic agents. Streptococcal infections from group A -hemolytic streptococcus (pharyngitis or perianal dermatitis) frequently trigger the appearance of guttate psoriasis in children, while stressful events induce new psoriatic lesions more commonly in juveniles than in adults, possibly due to adolescents’ emotional immaturity. Prior to the onset of this condition in children, a preceding streptococcal pharyngitis or perianal infection has been documented in several studies. A recent study by Augustin et al suggests that juvenile psoriasis may be associated with significant comorbidity (hyperlipidemia, obesity, hypertension, diabetes mellitus, rheumatoid arthritis, and Crohn’s disease), as is the case with adults.
Perineal Group A Streptococcal Disease In A Pediatric Practice
Streptococcal perianal dermatitis, a superficial bacterial infection of the anus and perianal skin in children, has also been linked with the appearance of guttate psoriasis. Although episodes may recur, especially those due to pharyngeal carriage of streptococci, isolated bouts have also been described. 10, 11 Perianal streptococcal infections, which often present as chronic pruritus of the anus in children, have also been associated with guttate psoriasis. The rate of nickel release from a given alloy is the most important risk factor for nickel-associated allergic contact dermatitis. Type 1 begins on or before age 40 years; Type II begins after the age of 40 years. Classically, guttate psoriasis occurs shortly after an acute group B haemolytic streptococcal infection of the pharynx or tonsils and can be the presenting episode of psoriasis in children or, occasionally, adults. In children, an acute episode of guttate psoriasis is usually self limiting;