The Latin word “Guttae” means a raindrop, and that sums up the appearance of scaly skin in guttate psoriasis, a skin inflammation that appears as a side effect of an immune system malfunction. Age is no barrier to acquiring the disease but children and young adults are more prone to outbreaks, regardless of gender.

Rashes appear as papules over the scalp, neck, chest, back, and limbs, but spontaneously vanish after weeks or months. Guttate is not a contagious condition so the patients don’t pose any danger to those in contact with them. The problem with leaving guttate psoriasis untreated is that you risk developing more dangerous forms of psoriasis-like pustular and erythrodermic psoriasis.  

What Are Guttate Psoriasis Causes?

Guttate psoriasis occurs as a rash of pinkish papules up to 1 centimeter in diameter. It is an inflammatory condition of the skin that develops as a result of a dysfunctional immune system. Though it’s scary to view, it is not a contagious disease. Dermatologists hold the view that guttate psoriasis causes are mainly genetic in origin.

It is theorized that a genetically mutated gene gets triggered or activated by external factors. Two such influences are the streptococcal throat infection and chickenpox which may trigger a guttate eruption. If it is purely guttate psoriasis, the eruptions usually subside without treatment. If left untreated, the patient may risk the danger of guttate psoriasis evolving into the more chronic plaque psoriasis.

What Are the Signs and Symptoms of Guttate Psoriasis?

The symptoms of guttate psoriasis may appear in one area of the skin surface and then disappear, only to reappear in another spot. Some people experience complete remission of symptoms. The visible signs and symptoms of guttate psoriasis should not be confused with other skin eruptions spurred by bacterial infection, so it’s best to consult a dermatologist to confirm the diagnosis:

  • Swathes of pinkish dewy drop-like papules spread as rashes across the body, usually on the back of a streptococcal throat infection, pharyngitis or tonsillitis.
  • The scalp, face, neck, and torso get covered with rashes in increasing numbers.
  • The papules appearing on the skin surface will not be thickened like plaques, but subsequent flare-ups after remission can turn into chronic plaque psoriasis.
  • The palms of the hands and soles of the feet are the only areas that are spared, possibly because of the thickness of the skin.
  • Around 33 percent of guttate patients may transition to plaque psoriasis, the chronic form of this skin condition.
  • Moderate to severe itching sensation pervades the areas covered by the rashes.
  • The symptoms may last weeks to months but will disappear on their own.
  • In colder countries, it is noticed that guttate psoriasis symptoms clear up faster in the summer months but the same symptoms are slower to subside in cold winter climates.

What Are the Guttate Psoriasis Stages?

Depending on the severity, three guttate psoriasis stages can be discerned:

  • In mild guttate psoriasis, very few papules cover roughly 3 percent of the skin surface.
  • In moderate guttate psoriasis, papules develop into thicker plaques covering 10 percent of the skin surface.
  • In severe guttate psoriasis, papules cover the entire body surface; this condition presents the toughest challenge and is very difficult to reverse.

It must be remembered that forms of psoriasis commonly affect people whose immune systems are compromised by various infections, disorders or therapies. Such people are prone to developing any or all three stages of guttate psoriasis:

  • People without access to healthy food and who are extremely malnourished.
  • People affected by autoimmune disorders where the body attacks its own healthy cells. Examples are rheumatoid arthritis, inflammatory bowel disease (IBD), and Type 1 diabetes mellitus.
  • Patients undergoing chemotherapy treatment for cancer.

What Are the Guttate Psoriasis Treatment Options?

Because guttate psoriasis disappears through spontaneous remission in weeks or months, many patients do not think it serious enough to warrant advanced medical care. This could be a mistake because left untreated, there’s the possibility that subsequent flare-ups may lead to more chronic conditions. To avoid future complications, it’s best to consult a dermatologist to explore guttate psoriasis treatment options:

Corticosteroids

Corticosteroids have introduced much flexibility in treating guttate psoriasis. Chiefly, they yield four important benefits:

  • Anti-inflammatory effect: A hyperactive immune system is mainly responsible for the spurt in skin inflammation. Steroids slow down the immune mechanism. This reduces cell damage and tissue inflammation and restores a degree of normalcy.
  • Anti-proliferative effect: One of the reasons for plaque or papule formation in psoriasis is the excessive growth of skin cells that get pushed up to the surface as scaly, flaky skin or papules. Steroids inhibit the growth of skin cells, so fewer new cells will be added. This allows the medication or therapy to show better results.
  • Immunosuppressive effect: The body’s immune system acts through white blood cells that signal each other to combat infection and disease-producing organisms. This causes inflammation. Steroids interfere with the process and suppress the inflammatory response in psoriasis.  
  • Vasoconstrictive effect: Steroids reduce the flow of blood to the affected skin, and this plays a role in reducing psoriasis inflammation.

The huge advantage of corticosteroids is that they come in seven ranges of potencies and can be deployed differently depending on the severity of guttate psoriasis.

Antimicrobial Drugs

Many cases have been documented where the guttate psoriasis outbreak follows a Streptococcal bacterial infection of the throat. Some people are known to be carriers of the bacterium in their upper respiratory passages. By using antibiotics, strep infections can be controlled and the trigger for psoriasis can be eliminated.  

Photochemotherapy

Psoralen assisted UVA therapy or PUVA therapy is an effective way of controlling guttate psoriasis outbreaks. Psoralen, a drug, is administered orally and gets activated in the presence of UV rays. Psoralen acts to bind with cell DNA to slow down cell growth and reduce inflammation.

Photochemotherapy is especially helpful when dealing with more extensive outbreaks of guttate psoriasis.

Laser Treatment for Guttate Psoriasis

When the papules are mild to moderate in coverage and localized in a few areas, an excimer laser gives the dermatologist a potent psoriasis eradication tool. Unlike in phototherapy that uses UV (A) light, the excimer laser focuses high-intensity UV (B) light only on the affected skin. It doesn’t touch healthy skin. The UVB light burns the superficial plaques and penetrates deeper into the scaly skin to suppress skin cell growth.

The handheld device is flexible enough to reach areas such as the scalp, elbows, knees, and the palms and soles of the feet. The technique is known to be effective in removing scalp psoriasis. The goal of laser treatment is to attack skin cell growth and reduce chances of a flare-up leading to chronic conditions.

Weight Reduction Goals

Guttate psoriasis is usually confined to the skin but it may penetrate deeper to affect organs and organ systems. As psoriasis grows in severity, the possibility of getting cardiac disease, diabetes, and cancers increase. Obesity is a trigger for guttate psoriasis that has linkages with nearly all lifestyle diseases. Therefore, reducing 10 to 15 percent of excess weight can dramatically improve guttate psoriasis symptoms and slow down flare-ups.  

What Is the Guttate Psoriasis Diet? Does It Relieve Symptoms?

Researchers at the University of California-San Francisco (UCSF) School of Medicine’s Department of Dermatology surveyed psoriasis patients to probe linkages between diet and psoriasis symptoms. The most successful guttate psoriasis diet followed by patients, though differing vastly, had some common features:

  • Reduced sugar intake.
  • Avoided milk and many dairy products.
  • Reduced or eliminated whole grain fiber, especially products rich in glutens. They settled for gluten-free foods such as buckwheat, corn, flax, and millets.
  • Generally avoided vegetables of the nightshade family like potatoes, tomatoes, eggplant, and peppers. Pushed consumption of green leafy vegetables such as spinach and kale.
  • Cut alcohol consumption substantially.
  • Favored fish and lean meat to red meat.
  • Took fish oil and Vitamin D supplements.

Conclusion

Guttate psoriasis is neither preventable nor curable, but it is possible to avoid severe outbreaks by taking reasonable precautions. Smoking, alcohol, and obesity are believed to act as triggers for the disease, so it’s in one’s best interests to avoid, reduce, or eliminate these triggers.

People with recurring respiratory infections (maybe as carriers of streptococcal bacteria) are known to be prone to psoriasis outbreaks. Prompt antibiotics treatment is necessary to nip this trigger in the bud.

Never underestimate the virulence and damage inflicting capacity of guttate psoriasis simply because it comes and goes. One day, it might decide to make your skin its permanent home by gestating into a chronic condition such as plaque psoriasis. A regular schedule of supervised medical care and treatment improves the quality of the guttate psoriasis patient’s life.