What Is Guttate Psoriasis?

Psoriasis—a chronic, inflammatory skin condition—affects more than 8 million people in the US alone. There are actually five different types of psoriasis: plaque, guttate, inverse, pustular, and erythrodermic.

Of all the five types, guttate psoriasis is a bit less common. "While psoriasis affects between 2% to 4% of the population, guttate psoriasis comprises only a small percentage of those patients," Bobbak Mansouri, MD, a board-certified dermatologist in Tyler, Texas, told Health. Roughly 8% of people that have psoriasis develop guttate psoriasis.

Here's everything else you need to know about guttate psoriasis, and the treatment options available.

What Is Guttate Psoriasis?

In addition to its rarity, guttate psoriasis is considered a "reactive psoriasis," Erum Ilyas, MD, a board-certified dermatologist in King of Prussia, Pennsylvania, told Health. That means “it’s often triggered by an immune system reaction to a viral or bacterial infection," said Dr. Ilyas.

This form of psoriasis appears as small, dot-like lesions and is actually named for its unique rash (the word "guttate" in Latin literally means "drops"). Guttate psoriasis manifests in small, salmon-pink patches that take the shape of raindrops and can erupt suddenly (again, typically after an infection like strep throat) on the trunk of your body but not your nails, palms, or the soles of your feet, where psoriasis typically appears, said Dr. Mansouri.

How Is Guttate Psoriasis Different From Other Forms of Psoriasis?

Unlike other forms of psoriasis, guttate psoriasis is typically seen in children and young adults. Another difference: The spots aren’t as solid as the ones from plaque psoriasis—they typically have a scaly, white appearance.

Just because you develop guttate psoriasis once doesn’t necessarily mean you will deal with psoriasis over the long term. "Many patients with guttate psoriasis will never deal with another breakout of psoriasis once their guttate psoriasis has resolved," said Dr. Mansouri. “Others will have flare-ups every now and then."

Guttate Psoriasis Symptoms

This type of psoriasis manifests in small, salmon-pink patches that take the shape of raindrops and can erupt suddenly (again, typically after an infection like strep throat) on the trunk of your body, but not your nails, palms, or the soles of your feet, where psoriasis typically appears, said Dr. Mansouri. These patches are called papules and are caused by inflammation in the skin. They may appear raised and scaly.

Other than the trunk of your body, the papules can be located on your:

• Arms
• Legs
• Face
• Ears
• Scalp

Guttate Psoriasis Triggers

Guttate psoriasis often develops after an infection, like strep throat. But it can also be triggered by certain medications like beta blockers or antimalarials or other infections like the flu, sinus infections or upper respiratory infections. Tonsilitis, skin injury, and stress are also common triggers for guttate psoriasis.

Treatments for Guttate Psoriasis

With guttate psoriasis in particular, the first step to finding a treatment that works is identifying the underlying infection that triggered guttate psoriasis, said Dr. Ilyas.

From there, treatment for that infection, as well as over-the-counter or prescription medications in topical form, are the first line in addressing the itchy skin and swelling. "We usually treat guttate psoriasis with topical steroids and/or nonsteroidal creams," said Dr. Ilyas.

Oral Medications

While a one-time treatment usually clears the condition, some people who develop guttate psoriasis do go on to develop chronic plaque psoriasis that resembles guttate psoriasis, added Dr. Mansouri.

If that’s the case, your healthcare provider may prescribe an oral medication. These medications are systemic, which means they work throughout your body.

Disease-modifying antirheumatic drugs (DMARDs)—typically given orally—are a category of drugs that attack inflammation instead of simply treating the symptoms. By targeting its action, DMARDs can reduce swelling and pain. A common DMARD is methotrexate, which inhibits an enzyme involved in the rapid turnover of skin cells.

Some other oral medications target a specific part of your immune system, such as an enzyme. Otezla and Xeljanz are some common oral medications in this category.

Injectable or Infusion Medications

If oral medications don't work, or your guttate psoriasis is more widespread, there are injectable or intravenous (IV) infusion medications. These drugs, also known as biologics, also target specific parts of the immune system, instead of the whole immune system.

Some common biologics include Humira, Cosentyx, Stelara, and Skyrizi. Each of these medications targets a different protein in your immune system.

Light Therapy

Still, for more serious cases, your dermatologist may also recommend light therapy, or phototherapy, directly on the affected skin. “Light therapy for psoriasis has been around for decades as it has been shown to help treat psoriasis by reducing certain inflammatory cells in the skin," said Dr. Ilyas.

While this therapy can be effective, the downside is that you may be required to undergo two to three treatments a week at your healthcare provider's office over the course of several weeks, Dr. Ilyas said.