The disease however can be confused with many other entities. Plaque psoriasis shows slightly different symptoms in kids. Guttate psoriasis is characterised by multiple small 'tear drop' lesions that tend to affect most of the body. Summary. Psoriasis is a chronic inflammatory disease that affects primarily the skin and joints. The differential diagnosis for guttate psoriasis includes lymphomatoid papulosis, pityriasis rosea, pityriasis lichenoides chronica, tinea versicolor, and secondary syphilis, although these conditions often have distinctive presentations . Skin biopsy is more informative. Viral exanthema should also be considered. It tends to affect children and young adults and has a good chance of spontaneously clearing. Guttate psoriasis often follows acute group B haemolytic streptococcal pharyngitis in persons genetically predisposed to psoriasis. Clinical differentiation between pityriasis lichenoides chronica (PLC) and guttate psoriasis (GP) may sometimes be a difficult task, which often requires histological analysis to reach a definitive diagnosis. It affects the face more in children than it does adults and it often appears in the nappy and flexural region when they are still in infancy. Usually starts with a single plaque (‘herald patch’), with colour from salmon to erythematous, followed by a generalised eruption after several days 2. The differential diagnosis of psoriasis includes dermatological conditions similar in appearance such as discoid eczema, seborrheic eczema, pityriasis rosea (may be confused with guttate psoriasis), nail fungus (may be confused with nail psoriasis) or cutaneous T cell lymphoma (50% of individuals with this cancer are initially misdiagnosed with psoriasis). Differential diagnosis. A careful history should be taken to exclude certain drugs, such as beta-blockers and lithium, which may cause an eruption similar to that of guttate psoriasis. Guttate psoriasis may be confused with: Discoid dermatitis (more itch, vesicles, dry rather than plate-scale) Tinea corporis (elevated border, slowly extending edge, positive mycology) Pityriasis rosea (herald patch, fir-tree distribution of oval plaques, trailing scale) Erythrodermic psoriasis may be confused with: The rash comes on very quickly and may follow a streptococcal infection of the throat. It accounts for 2% of the total cases of psoriasis (1). Differential diagnosis of psoriasis including plaque psoriasis, guttate psoriasis, palmoplantar psoriasis and flexural psoriasis. Scalp Table 1. Differentiating features. The differential diagnoses of guttate psoriasis include tinea corporis, secondary syphilis, nummular eczema, and pityriasis rosea. - Guttate psoriasis 1 - Guttate psoriasis 2 - Pityriasis rosea dark skin - Pityriasis rosea trailing scale - Pityriasis rosea with herald patch - Tinea corporis - multiple lesions - Tinea corporis 3 - Papular secondary syphilis - Palmar rash secondary syphilis - Pityriasis lichenoides chronica - Nummular eczema legs - Nummular eczema legs 2 - Viral exanthem close view Guttate psoriasis (also called eruptive psoriasis) ... which are usually enough for the differential diagnosis. The diagnosis of psoriasis can be made by clinical observation without laboratory tests in most cases. The keywords used were “psoriasis,” “plaque psoriasis,” “differential diagnosis,” “diagnosis,” and “papulosquamous lesions.” Reviews and original articles published up to 1 September 2020, including case reports, assessing the description of the clinical presentations and differential diagnosis for psoriasis, were included. 1 Below is a review and update on the assessment, diagnosis, and treatment of psoriasis. The disease manifests following exposure to various triggers (e.g., infection, medication). Differential diagnoses include atopic der- Evaluation and differential diagnosis.Less common variants of psoriasis include inverse psoriasis, pustu-lar psoriasis, guttate psoriasis, erythrodermic psoriasis, and annular psoriasis (Figures 3). Von Zumbusch psoriasis, also known as acute generalized pustular psoriasis, is a rare type of psoriasis characterized by white, pus-filled blisters (pustules). The pustules are not contagious but are the result of sudden and extreme autoimmune inflammation. The plaques aren’t as thick and the lesions are less scaly. 3 Skin scrapings and nail clippings may be requiredto exclude tinea. In this study, PLC and GP lesions were examined using dermoscopy, and the significance of s … The second most common form is localized pustular psoriasis of the palms and soles. The differential diagnosis includes pityriasis rosacea, tinea corporis, secondary syphilis, pityriasis lichenoides chronica, nummular dermatitis, and drug eruptions. Misdiagnosis of Guttate psoriasis including hidden diseases, diagnosis mistakes, alternative diagnoses, differential diagnoses, and misdiagnosis. Nummular eczema, tinea corporis, cutaneous T-cell lymphoma, atopic dermatitis, contact dermatitis and yeast infections in skin folds can all be confused with psoriasis. Guttate psoriasis Microscopic (histologic) description Parakeratosis without hyperkeratosis, acanthosis with downward elongation of rete ridges (resembles a comb), thin / no granular cell layer, suprapapillary thinning (attenuated layer of epidermal cells above tips of dermal papillae), Munro microabscesses (neutrophils in parakeratotic scale) Conditions to consider in the differential diagnosis of guttate psoriasis 1,2; Disease. Guttate psoriasis is a form of psoriasis that often appears in the wake of strep throat and other similar infections. 1 The condition is triggered and worsened by some medications, infections, skin trauma, obesity, and stress, and those suffering from psoriasis are at higher risk for both cardiovascular disease and depression. Psoriasis is a common chronic inflammatory skin disorder affecting individuals with an underlying genetic predisposition. Important for differential diagnosis, the uniform distribution of the red dots within the lesion represents the dermoscopic hallmark of psoriasis. Psoriasis () Definition (MEDLINEPLUS) Psoriasis is a skin disease that causes itchy or sore patches of thick, red skin with silvery scales. The keywords used were psoriasis, plaque psoriasis, differential diagnosis, diagnosis, and papulosquamous lesion s. Reviews and original articles published up to 1 September 2020, including case reports, assessing the description of the clinical presentations and differential diagnosis for psoriasis, were included. Diagnosis of Guttate Psoriasis Diagnostic considerations. Other forms of psoriasis include: Guttate psoriasis. You usually get the patches on your elbows, knees, scalp, back, face, palms and feet, but they can show up on other parts of your body. In a majority of patients it is a self limiting condition (2). Differential diagnosis ... Guttate psoriasis is more common in children and adolescents. The PASI score is the ‘Psoriasis Area and Severity Index’, and is mainly used for evaluating the effect of interventions in clinical trials. These entities can be differentiated from guttate psoriasis based on history and physical examination with skin biopsy when necessary. Pityriasis rosea. You usually get the patches on your elbows, knees, scalp, back, face, palms and feet, but they can show up on other parts of your body. The blood tests are aimed at determining the non-specific signs of inflammation (leukocytosis, an increase of erythrocyte sedimentation rate, rheumatoid factor). Epidemiology. It may be precipitated by a streptococcal infection 2-4 weeks prior to the lesions appearing. Plaque psoriasis may be confused with: Discoid dermatitis (more itch, vesicles, dry rather than plate-scale) It is calculated as follows: Differential diagnosis. The clinical features include: … Incidence: 5.00 cases per 100,000 person-years; Differential diagnosis Discoid eczema . Guttate psoriasis can be distinguished from these entities by history and physical exam, although further studies such as potassium hydroxide (KOH) scrapings and serologies may be helpful in ruling out the other disorders in the differential diagnoses. Psoriasis is a skin disease that causes itchy or sore patches of thick, red skin with silvery scales. Lesions are less well defined and may be exudative or crusted, lack ‘candle grease’ scaling, ... 2 Throat swabbing for β-haemolytic streptococci is needed in guttate psoriasis. Background: Psoriasis is an inflammatory skin disease presenting with erythematous and desquamative plaques with sharply demarcated margins, usually localized on extensor surface areas. Psoriasis: Epidemiology, clinical manifestations, and diagnosis View in Chinese … with pre-existing psoriasis. 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