MeSH Terms. Acute Disease; Adolescent; Glomerulonephritis/complications; Humans; Male; Psoriasis/complications; Streptococcal Infections/complications. 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. Generally, the disease is self-limiting, but a certain percentage of cases progress to chronic plaque psoriasis. However, reported cases have failed to prove association of psoriasis and poststreptococcal renal disease. Psoriasis is a long-lasting autoimmune disease characterized by patches of abnormal skin. This form of psoriasis is characterized by an acute onset of numerous pustules on top of tender red skin. Patients undergoing systemic treatment must have regular blood and liver function tests to check for medication toxicities.
The disease is managed through treatment. It can make life-threatening demands on the heart and kidneys. Learn more from WebMD about guttate psoriasis and its link to illnesses like strep throat and tonsilitis. Caution is taken with the dosing of this drug in those who have reduced kidney function. Early detection and treatment of such infections may prevent an acute flare-up of the skin disease. The estimated prevalence of severe GAS disease (e.g., acute rheumatic fever, rheumatic heart disease, post-streptococcal glomerulonephritis, and invasive infections) is 18 million cases. 12 Several immune mechanisms may be operable in post streptococcal syndromes such as antibody directed molecular mimicry in rheumatic fever,13,14and possible super antigen stimulation of T cells in Kawasaki disease and guttate psoriasis.15,16. 80 Renal disease is usually limited and the prognosis is good, although occasionally patients develop progressive renal failure with nephrotic syndrome.81,76 Treatment for progressive renal disease includes steroids and cytotoxic agents.
This is a rare and severe form of psoriasis, in which the skin surface becomes scaly and red. People with kidney problems should use anthralin with caution. Psoriasis is rare in infants and common in children and young age groups. Infections: The role of streptococcal infection, especially in the throat, in provoking acute guttate psoriasis has long been recognized and this gives an explanation to the improvement of psoriatic lesions after a course of antibiotics for treatment infections of tonsillitis or laryngitis. The disease appears first in the scalp, where lesions appear as scaly patches on the scalp and may spread later to involve different skin sites mainly on the extremities and trunk. Dialysis has some effect on psoriasis in patients with normal renal function and that peritoneal dialysis is more effective than haemodialysis, possibly because substances of higher molecular weight can be removed in larger quantities. By recognizing cutaneous manifestations of systemic diseases, the internist can often determine the appropriate diagnosis and therapy or the need for referral to a dermatologist. Differential diagnosis includes psoriasis, atopic dermatitis, allergic or irritant contact dermatitis, and dermatophyte (tinea) infections. Treatment includes elimination of known causes, antihistamines (H1 and H2 blockers), oral corticosteroids for acute flares, and, in refractory cases, immunosuppresants such as sulfasalazine and cyclosporine. Nephrogenic systemic fibrosis occurs in patients who have end-stage renal disease and are on dialysis and occasionally in patients with acute renal failure or after kidney transplantation.
Psoriasis Facts, Information, Pictures
Guttate psoriasis should clue the provider to the need to screen for streptococcus. Close monitoring is required since renal toxicity and hypertension are common and often limit the long-term use of cyclosporine in patients with psoriasis. Plaque psoriasis (psoriasis vulgaris), the most common form of the disease, is characterized by small, red bumps that enlarge, become inflamed, and form scales. Often found on the arms, legs, and trunk and sometimes in the scalp, guttate psoriasis can clear up without treatment or disappear and resurface in the form of plaque psoriasis. Widespread, acutely painful patches of inflamed skin develop suddenly. Generalized pustular psoriasis can make life-threatening demands on the heart and kidneys. Chronic plaque psoriasis is the most common type, affecting approximately 90 of people with psoriasis. Figure 1: Treatment pathway for psoriasis management NICE recommends topical therapy as first-line treatment, with initial use of daily potent steroid treatment and daily calcipotriol for plaque psoriasis. There is also increased risk of chronic kidney disease in patients with severe psoriasis, independent of traditional causes, especially younger patients. Methotrexate is licensed for the treatment of severe psoriasis, psoriatic arthritis, rheumatoid arthritis, and a number of malignancies, including: childhood acute lymphoblastic leukemia, lymphoproliferative disorders, choriocarcinoma, and various solid organ tumors. Renal function was normal and methotrexate level measured at the time of admission was undetectable. It maybe unsuitable for patients with severe liver disease. The excessive methotrexate can in turn damage the kidneys further. Pre-treatment laboratory tests usually include a full blood count with differential (CBC), kidney function tests (creatinine), liver function tests, HbA1c (a test for diabetes), and lipids.
However, some young patients eventually develop plaque psoriasis. In the exanthematic type, there are no systemic symptoms. Patients experience acute eruptions of small pustules lasting several days, then clearing completely. Antisynthetase syndrome: A rare autoimmune disease that affects the muscles. A rare disease involving inflammation of membranes in the lung and kidneys. Guttate psoriasis: Guttate psoriasis refers to a distinctive, acute clinical presentation of an eruption characterized by small, droplike, 1-10 mm in diameter, salmon-pink papules, usually with a fine scale.