Aimee said: "It was in January when I went through a really tough break up with the man I thought I would spend the rest of my life with and I was struck down with tonsillitis that it became
guttate psoriasis - which is smaller patches spread across the body.
(1,2) Specifically, this association appears to be with both
guttate and plaque psoriasis.
Regarding the frequency of different types of psoriasis Table 2 shows that out of 50 cases of psoriasis maximum incidence was of psoriasis vulgaris with 16 (32%) cases followed by 14 (28%) patients of
guttate psoriasis.
Clinically different types of psoriasis were seen during the study in which chronic plaque psoriasis was most common (255 patients-74.56%) followed by palmoplantar psoriasis (99 patients-28.95%), sebopsoriasis (69 patients-20.17%),
guttate psoriasis (66 patients-19.29%), flexural psoriasis (60 patients-17.54%), pustular psoriasis and psoriatic arthritis (each 12 patients-3.50%) and psoriatic erythroderma (9 patients-2.63%) (Table 4).
Acute lesions include small
guttate lesions, erythroderma, and Psoriatic arthritis and nail involvement.
The most common type of psoriasis in our study was plaque psoriasis (85.1%), followed by
guttate psoriasis (2.9%), erythrodermic psoriasis (1.7%), and pustular psoriasis (1.0%).
Majority of respondents were diagnosed as chronic plaque psoriasis (51%) among acute
guttate psoriasis
guttate flare of chronic plaque psoriasis deterioration of chronic plaque psoriasis and pustular psoriasis.
The authors suggested that HK may be a "hyperkeratotic" variant of idiopathic
guttate hypomelanosis [2].
Rarely biopsy may be needed to differentiate from other hypopigmentation disorders such as Lupus erythematosus , Pityriasis alba, Tuberculoid leprosy, Post inflammatory hypopigmentation, Tinea versicolor, Piebaldism, Idiopathic
guttate hypomelanosis, Progressive macular hypomelanosis, Chemical leukoderma, Post-inflammatory hypomelanosis and Primary adrenal insufficiency.
Exclusion criteria were acute
guttate pustular severe or erythrodermic psoriasis psoriasis which is predominantly located in the skin folds face or scalp treatment for plaque type psoriasis with corticosteroid agents vitamin D analogues or tacrolimus within the last 3 months systemic anti-psoriatic treatment or PUVA within 16 weeks period prior to visit pregnant or lactating women patients under treatment with retinoids or antibiotics patient with known or suspected renal/ hepatic disease/ hematological disease and history of acute or chronic active infections.
Rao et al, (6) found macular lesions in 86.60% of patients, follicular in 6.60% of patients, confluent in 10% of the patients and
guttate in 1.60% of patients.
Acute
guttate psoriasis is strongly associated with preceding and concurrent streptococcal infection particularly of the throat.3 In one study streptococci were isolated from the throat of 97 Percent patients with
guttate psoriasis.4 Although streptococcal throat infection can clearly trigger the
guttate psoriasis only 20-30 Percent throat culture cases were positive in chronic plaque type
