PDF Source for ‘Although the association between streptococcal infection and guttate psoriasis is well known, to date there has been little information on whether only limited groups and/or serotypes of beta-hemolytic streptococci are involved. 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. file6372 file6373 file6374 See Psoriasis: Manifestations, Management Options, and Mimics, a Critical Images slideshow, to help recognize the major ps. The sudden appearance of the papular lesions in response to streptococcal infection could either be the first manifestation of psoriasis in a previously unaffected individual or an acute exacerbation of long-standing plaque psoriasis. G. The role of streptococcal infection in the initiation of guttate psoriasis. Figure 1 Acute guttate psoriasis on arms and trunk. Although otherwise well, his perianal area has been red and itchy for the last month, and zinc oxide paste has not helped. Colman G. The role of streptococcal infection in the initiation of guttate psoriasis.
Background: The role of streptococcal infection in the initiation of guttate psoriasis is well recognized, but the treatment results with oral erythromycine and phenoxymethylpenicillin are conflicting. Streptococcal infections are well known to precipitate guttate psoriasis,1 however there have been no significant improvements in patients who were given penicillin or erythromycin when compared to those who were not treated. The role of streptococcal infection in initiation of Guttate Psoriasis., Telfer,Chalmer. The choice of treatment for guttate psoriasis is hampered by the lack of controlled trials for the available therapies, as Drs Caroline Owen and Robert Chalmers report. The disadvantages of topical corticosteroids are well known, but mild to moderate preparations may be used for up to 4 weeks at a time. G. The role of streptococcal infection in the initiation of guttate psoriasis.
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. Good prognosis is associated with younger age and high ASO titres, whilst poorer prognosis is associated with a family history of psoriasis. An outbreak of guttate psoriasis may be an immune reaction that is triggered by a previous streptococcal infection or some other type of infection. Even though the connection between these infections and the outbreaks has been known for over 50 years, the exact mechanism by which the infection triggers the lesions is unknown. Patients who are sensitive to penicillin generally do well on erythromycin. The role of streptococcal infection in the initiation of guttate psoriasis.
Antistreptococcal Treatment Of Guttate Psoriasis: A Controlled Study
The role of infection in precipitating psoriasis is well known. Thus if there is cross- reactivity between streptococcal antigens and keratinocyte components, this could explain the initiation of a disease process. Learning points: The differential diagnosis for the well-appearing patient with a scaly, diffuse rash is relatively broad. The role of streptococcal infection in the initiation of guttate psoriasis. The role of streptococcal infection in the initiation of guttate psoriasis. Gudjonsson – Br J Dermatol 2003 abstract / PubMed IgG class antibodies from psoriasis patients recognize the 60-KDa heat-shock protein of Streptococcus pyogenes. This triggered the production of Th1, Th17, and Th22 cytokines, as well as epidermal cell mediators (CXCL8, CXCL9, CXCL10, and CXCL11). It is well known that PG is a strong pro-inflammatory stimulus in chronic inflammation through its interaction with dendritic cells (DCs) and monocytes via pattern recognition receptors including Toll-like receptor 2, nucleotide-binding oligomerization domains 1 and 2 and PG recognition proteins 1 4. G. The role of streptococcal infection in the initiation of guttate psoriasis.