- Common in adolescents and young adults.
- Often follows an acute streptococcal infection.
- May occur in patients with or without history of psoriasis.
- The patient may or may not have further problems with psoriasis.
- Acute onset of rash.
- Usually on the trunk and limbs.
- Discrete, droplike (guttate), deep red papules often with silvery scale.
- May be self-limiting and usually resolves within four months.
- Emollients, topical steroids or vitamin D analogue.
- Ultraviolet light, if widespread and not practical to apply ointments.
- Affects children and young adults.
- Small, widespread, pink papules that become reddish brown
- In acute cases the rash may develop pink necrotic papules.
- Post-inflammatory hyperpigmentation.
- Most often occurs on trunk and inner aspect of the limbs.
- Often symptomless but the patient may be feverish and unwell.
- The chronic form may last for months or years. The acute form usually settles after four to eight weeks.
- Ultraviolet light.
- Topical steroids if irritation. Oral antibiotics.
- Topical immodulators such as tacrolimus.
- For resistant cases systemic steroids, methotrexate, acetretin, dapsone or ciclosporin
- Relapses often occur when treatment is discontinued
- Regular follow up as malignant change has been reported.
Contributed by Dr Jean Watkins, a GP in Ringwood, Hampshire