Clinical course of guttate psoriasis: Long‐term follow‐up study

Abstract

Guttate psoriasis, known to have a better prognosis than other types of psoriasis, shows rapid involution and longer remission, but its clinical course has barely been studied. The aim of this study was to determine the clinical course and to compare the clinical and laboratory features of guttate psoriasis. This is a retrospective study of 26 patients with guttate psoriasis. The patients were divided into two groups; the good one with complete remission and long remission for at least 1 year (group A) and the poor one with incomplete remission and progression into chronic plaque psoriasis (group B). Among 36 patients, 22 patients (61.1%) were group A and 14 patients (38.9%) were group B. In group A, most of the skin lesions disappeared within 8 months. In group B, two patients without proper treatment progressed to plaque psoriasis. The onset age was younger and more frequent upper respiratory infection and high anti-streptolysin O (ASO) titer were found in group A, but family history of psoriasis was more common in group B. Patients had two distingushable clinical courses: rapid involuting course with long-term remission and chronic course without remission. There was a tendency toward younger age of onset with elevated ASO titer in patients with rapid involuting course.

Phototherapy with Narrow-Band UVB in Adult Guttate Psoriasis: Results and Patient Assessment

“…AGP occurs more frequently in childhood, and a recent study of 314 patients seen in childhood with guttate psoriasis still had it in adulthood [4] . Maybe there are 2 forms of evolution of an AGP over the years as was proposed in previous works [5] , but this does not necessarily involve a change of clinical type. The patients with CR and IR in our study showed some significant differences which could promote 2 different clinical courses, spontaneous healing or chronicity in outbreaks.…”

“…Traditionally, patients with AGP have been divided into 2 groups in terms of prognosis, one showing CR and the other progressing into chronic plaque psoriasis without complete involution [20] . The exact percentage of AGP progressing into chronic plaques is not clear and varies in the studies from approximately 15-30% [4] to 68% with a follow-up period up to 10 years [5,[20][21][22][23] . In contrast, none of our patients with more than 1 flare of psoriasis (n = 43) presented another clinical type of psoriasis despite being adults with a mean evolution of 6.62 years.…”

Guttate Psoriasis Can Present With Psoriatic Arthritis after Urinary Tract Infection: Case Report

“…2 Of psoriasis, guttate psoriasis is a distinct eruptive dermatosis that classically occurs in children and young adults following upper respiratory tract infection. 3 It might present as either the initial manifestation of psoriasis in individuals previously unaffected by psoriasis or as an acute exacerbation in individuals with pre-existing chronic plaque psoriasis. Guttate psoriasis is strongly associated with antecedent or concomitant streptococcal infection and of-ten occurs 1 to 2 weeks after streptococcal pharyngitis or a viral upper respiratory infection.…”

“…6 Although, limited information is available about the long-term prognosis of individuals with first-manifestation of guttate psoriasis. 5 Ko et al 3 reported that patients have two distinguishable clinical courses, a rapid involution course with longterm remission and a chronic course without remission. Others reported that approximately 33% of patients with guttate psoriasis might eventually develop chronic plaque psoriasis.…”

Association of psoriasis and tinea capitis in a child

“…In genetically susceptible individuals, innate immune mechanism activation and stimulation of T cells trigger psoriasis but the exact stimulus is still unknown (Fry and Baker, 2007;Roberson and Bowcock, 2010). Although streptococcal infections are reported to be the causative agent in guttate form, other infectious agents are still in search (Ko et al, 2010).…”