Which physical findings are characteristic of guttate psoriasis?

Updated: Oct 03, 2019
  • Author: Kirstin Altman, MD; Chief Editor: Dirk M Elston, MD  more...
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Answer

Answer

Examination of the skin reveals characteristic lesions consisting of multiple, discrete, 1-10 mm in diameter, droplike papules with a salmon-pink hue. A fine scale, which is usually absent in early-stage lesions, may be appreciated on the more established ones, as shown in the image below.

Guttate psoriasis. Note characteristic lesions con Guttate psoriasis. Note characteristic lesions consisting of multiple, discrete, droplike papules with a salmon-pink hue. A fine scale, which is usually absent in early-stage lesions, may be appreciated on the more established ones. Courtesy of Hon Pak, MD.

The lesions of guttate psoriasis appear first on the trunk and the proximal extremities, progressing in a centripetal fashion. Lesions are commonly monomorphic and at the same stage of evolution. They may sometimes spread to involve the face, the ears, and the scalp. The palms and the soles are rarely affected. Nail changes in the form of pits, ridges, and the oil-drop sign, which are characteristic of chronic psoriasis, may be absent

Additional findings may include pharyngeal or perianal erythema in cases associated with acute streptococcal infections. Ledoux et al emphasize a careful examination, including the perianal region, in children being examined for guttate psoriasis. [5]


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