Multiple Small Plaques of Psoriasis

May 10, 2013

Guttate psoriasis often appears in conjunction with an upper respiratory infection, particularly streptococcal tonsillitis, as it did in this patient. This phenomenon is more common in children.

A 56-year-old man sought medical attention because of the sudden appearance of a rash on the trunk and extremities. Immediately before presentation, he had experienced a severe upper respiratory tract infection, which included pharyngitis.

Key point: The patient’s eruption largely consists of multiple small plaques of psoriasis. There was a notable paucity of large plaques. Scalp and nails were normal. This is a good example of guttate (“drop-like”) psoriasis.

Treatment: The patient responded well to topical mid-potency topical corticosteroid application combined with narrow band UVB phototherapy.

Note: Guttate psoriasis often appears in conjunction with an upper respiratory tract infection, particularly streptococcal tonsillitis. This phenomenon is more common in children.