What is guttate psoriasis and how to deal with the disease? Guttate psoriasis (also called eruptive psoriasis) is a non-infectious skin disease which is characterized by the unpredictable occurrence of lesions. That makes the healing process of the disease very difficult. The lesions can appear on different parts of the skin and at different ages. People of 16-27 are the most vulnerable to the disease. The main symptoms are rashes which may look like small dots and spots of about 10 cm diameter.
Guttate Psoriasis Causes
Guttate psoriasis causes are still not completely known. All existing hypotheses lead to immune disorders as the basis of the disease.
Like many other allergic diseases, psoriasis is a multifactorial illness. To occur, it has to be based on several external and internal factors.
Internal causes of the disease are:
- genetic predisposition. One has more chances to get sick if one’s close relatives suffer from the disease;
- dysfunction of nervous and endocrine systems;
- pathology of metabolism caused by liver, intestines and kidneys failure, severe chronic diseases (diabetes, etc.);
- infectious diseases of viral, bacterial and mycotic (fungal) nature;
- hormonal disorders;
- peculiarities of the skin structure (too thin and dry skin is most often affected);
- streptococcal infections;
- some drugs (including antimalaria drugs and beta-blockers).
Streptococcal throat infection (acute pharyngitis) is a common factor that can cause the symptoms of psoriasis. Acute pharyngitis may be asymptomatic. If you have an outbreak of guttate psoriasis symptoms, you should better visit your doctor and get a test for streptococcal infection.
Apart from acute pharyngitis, the outbreak of guttate psoriasis may be caused by external factors:
- skin damage of different nature (physical damages like burns, cold injury, surgery, tattoos, bites, radiation; chemical damages by acids, alkalis, contact poisons, and other substances);
- intoxication (everyday life and industrial toxins, alcohol, drugs, medications);
- improper feeding;
- environmental risks;
- a sudden change in weather conditions;
- stressful situations, emotional upheaval.
Psoriasis Development Mechanism
During the disease, the life cycle of epidermis cells accelerates dramatically. They mature quickly and quickly die off without reaching the mature phase. The cells’ abridged life period leads to weakening of the epidermal layer. Externally, these changes appear as scaly spots which are the main symptom of psoriasis.
It is believed that the epidermal damage is caused by one’s own immune system which perceives the cells of the skin surface layer as foreign agents. The inflammatory response leads to the death of cells in the epidermis and their exfoliating.
Guttate Psoriasis Symptoms
The small, red, and individual spots that appear on the body are the main guttate psoriasis symptoms. These guttate lesions usually appear on the trunk and extremities and may number in hundreds. Sometimes the lesions appear on the scalp, on face, and ears. They are generally not as thick as the plaques of plaque psoriasis. Guttate psoriasis may precede or coexist with other forms of psoriasis such as plaque psoriasis.
According to the statistics, in most clinical cases guttate psoriasis develops in teenagers and its symptoms are not always detected at an early stage. The appearance of papules can be triggered by otitis, tonsillitis, and other infectious diseases. The progress of guttate psoriasis is impossible to predict. The papules appear in various places. They may completely regress in one place, but later they can appear in a different place to survive and progress there. Is guttate psoriasis contagious? It must be mentioned that guttate psoriasis is not a contagious disease, and thus the patient is not dangerous to others.
How long does guttate psoriasis last? The disease may disappear completely when the patient is growing up, but not always. In other cases, it is transformed into other forms of psoriasis.
Guttate Psoriasis Pictures
Guttate Psoriasis Stages
The severity of the disease is based on the size of the affected area and the size of the papules. There are three guttate psoriasis stages:
- mild guttate psoriasis: up to 3 percent of the patient’s skin are affected and there are only a few papules;
- moderate psoriasis: the plaques occupy up to 10 percent of the skin;
- severe psoriasis can cover the entire body; it is very difficult to cure.
Patients with weakened immune systems may suffer from severe psoriasis. This group of people includes:
- people with very poor diet and living in poor conditions;
- people suffering from autoimmune disorders, including rheumatoid arthritis;
- patients undergoing chemotherapy for cancer.
When scraping papules one can notice the psoriatic triad:
- at first, whitish scaly crusts appear; they vaguely resemble stearin (the stearin spot phenomenon);
- after complete removal of crusts moist shining surface appears (the phenomenon of terminal film);
- tiny drops of blood appear after further scraping (the phenomenon of blood dew).
Guttate psoriasis in children tends to form small lesions. Sometimes (when located under the diaper) psoriatic lesions can be taken for diaper rash by mistake.
It doesn’t mean that the patient is cured if the rash had disappeared. Psoriasis can appear again after the decrease in immunity (infectious diseases for instance). Seasonal exacerbations are likely to happen too (there are spring and autumn types of the diseases).
The doctor usually pays attention to the complaints (rash, itchy papules, psoriasis triad) which are usually enough for the differential diagnosis.
The blood tests are aimed at determining the non-specific signs of inflammation (leukocytosis, an increase of erythrocyte sedimentation rate, rheumatoid factor).
Skin biopsy is more informative. It reveals the immaturity of the epidermal cells in their thickening layers and discovers immune cells among them (T-lymphocytes).
Guttate Psoriasis Treatment
When talking about guttate psoriasis treatment one should keep in mind that the causes and pathological mechanisms of psoriasis are still under discussion. The treating process is considered conventional and its main goal is to achieve sustained remission (the state when there are no symptoms of the disease).
To treat guttate psoriasis, as well as other forms of the disease, doctors prescribe drugs for general and local action. The combination of drug therapy and physiotherapeutic procedures make the best treatment for guttate psoriasis.
Here are the main remedial measures for psoriasis guttate:
- Hypoallergenic diet (the foods to avoid are the ingredients of animal origin (meat and fat), smoked products, canned food, spices; the diet must include a lot of plant food, a sufficient volume of water (not less than 1.5 liters per day).
- Normalization of psychological state. Patients are prescribed antianxiety drugs or tranquilizers and antidepressants, if necessary. It is important to avoid stress and create comfortable emotional atmosphere.
- Refusal of bad habits which exacerbate intoxication (smoking, alcohol, psychostimulants).
- Antihistamines are used to reduce the effects of inflammatory mediators (depending on the doctor’s advice).
- Vitamin therapy (A, E vitamins, derivatives of vitamin D).
- Glucocorticosteroids to reduce the inflammatory response.
- Plasmapheresis (a method of cleaning blood from toxic immune complexes and ballast substances).
- Monoclonal antibodies to neutralize the autoimmune reactions.
- Ultraviolet radiation of psoriatic lesions as an independent method or after the administration of photosensitizing agents (PUVA).
- Cytotoxic agents (drugs that slow down cell division).
- Local cryotherapy (cold treatment by liquid nitrogen mostly).
- An ointment or cream with salicylic acid and steroids.
In addition to traditional methods, one can use natural remedies for guttate psoriasis treatment. Here are some home remedies patients often use in addition to the main remedies:
- Take bur-marigold leaves and alcohol in equal proportions, mix the ingredients and leave them for 3 days. Then mix the liquid portion of the infusion with 1 jar of Vaseline and 1 jar of lanolin. Apply the mixture to the affected area 2 times a day for 2-3 weeks.
- Every morning drink a teaspoon of sea buckthorn oil. Use the same oil to smear the papules and plaques. The period of application is not limited.
- Daily baths with any of the herbs you choose (valerian, celandine, sage, bur-marigold, tutsan). Mix 4 tablespoons of the herb with 1 liter of boiling water and leave the brew for 6-8 hours. Then add the strained brew into the bath. Take the bath for 15-20 minutes. You should take up to 20 baths.
When trying to get rid of guttate psoriasis with home remedies you should keep in mind that psoriasis is not completely curable even with drug treatment. The insufficient knowledge about the mechanisms of its appearance makes the treatment of the disease very challenging. Self-medication may be ineffective and can lead to severe psoriasis.
Efficiency and cost of treatment of guttate psoriasis depend on the reason and the stage of the disease.
Sometimes to have a positive result one has to take medications. Sometimes one may need a complex therapy which includes plasmapheresis and phototherapy. Treatment may be more effective if one combines medications with home remedies. Still, it is advisable to contact the doctor first.
Guttate psoriasis can be treated effectively if diagnosed at an early stage. In this case, one can avoid the severe stage of the disease. This stage of guttate psoriasis cannot be self-medicated. You have to consult the doctor.
As for the prognosis of guttate psoriasis, one should know that the skin may become completely clear after the course of treatment. Still, guttate psoriasis can sometimes turn into a lifelong health condition or chronic plaque psoriasis.