Guttate Psoriasis: A Case Report

Detalhes bibliográficos
Autor(a) principal: Fonseca, Sara
Data de Publicação: 2019
Outros Autores: Pereira, Ana Paula, Pais, Patrícia, Marques, Inês
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
Texto Completo: https://doi.org/10.25754/pjp.2019.17189
Resumo: Psoriasis is an inflammatory, immune-mediated disease with chronic and recurrent evolution. It results from the interaction between genetic predisposition and endogenous and/or exogenous triggering factors, with an imbalance in the predominantly autoimmune immune response. In guttate psoriasis, which is more prevalent in children and young adults, the association with pharyngitis and/or tonsillitis by group A β-hemolytic Streptococcus is frequent, and the antigens will trigger the immune-mediated response in a field of greater genetic susceptibility, as evidenced by the association with the HLA-cw6 allele. Classical clinical findings include the sudden onset of numerous small papules and erythematous, desquamative plaques, usually located on the trunk, tear drop-like, or often described as droplet psoriasis. In the literature, patients with guttate psoriasis have been reported to develop plaque psoriasis. We describe the case of a 17-year-old girl with a recent history of acute streptococcal tonsillitis who had recourse to the Emergency Department for erythematous, scaly and pruritic micro-papillary lesions initially located in the palms of the hands and later dispersed in the trunk, abdomen and limbs, with appearance of erythematous and scaly plaques on the elbows. No fever. No family history of psoriasis. There were no other changes in physical examination. Based on the hypothesis of guttate psoriasis, he underwent a skin biopsy that corroborated the diagnosis. He started topical treatment, with vitamin D derivative and topical corticosteroid, and phototherapy (ultraviolet B) with favorable evolution. Maintained follow-up in Consultation with evolutionary surveillance for chronicity, namely in the form of plaque psoriasis. Keywords: Guttate Psoriasis, Streptococcal Infections, Teenager
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spelling Guttate Psoriasis: A Case ReportImages in PediatricsPsoriasis is an inflammatory, immune-mediated disease with chronic and recurrent evolution. It results from the interaction between genetic predisposition and endogenous and/or exogenous triggering factors, with an imbalance in the predominantly autoimmune immune response. In guttate psoriasis, which is more prevalent in children and young adults, the association with pharyngitis and/or tonsillitis by group A β-hemolytic Streptococcus is frequent, and the antigens will trigger the immune-mediated response in a field of greater genetic susceptibility, as evidenced by the association with the HLA-cw6 allele. Classical clinical findings include the sudden onset of numerous small papules and erythematous, desquamative plaques, usually located on the trunk, tear drop-like, or often described as droplet psoriasis. In the literature, patients with guttate psoriasis have been reported to develop plaque psoriasis. We describe the case of a 17-year-old girl with a recent history of acute streptococcal tonsillitis who had recourse to the Emergency Department for erythematous, scaly and pruritic micro-papillary lesions initially located in the palms of the hands and later dispersed in the trunk, abdomen and limbs, with appearance of erythematous and scaly plaques on the elbows. No fever. No family history of psoriasis. There were no other changes in physical examination. Based on the hypothesis of guttate psoriasis, he underwent a skin biopsy that corroborated the diagnosis. He started topical treatment, with vitamin D derivative and topical corticosteroid, and phototherapy (ultraviolet B) with favorable evolution. Maintained follow-up in Consultation with evolutionary surveillance for chronicity, namely in the form of plaque psoriasis. Keywords: Guttate Psoriasis, Streptococcal Infections, TeenagerSociedade Portuguesa de Pediatria2019-11-12info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articlehttps://doi.org/10.25754/pjp.2019.17189eng2184-44532184-3333Fonseca, SaraPereira, Ana PaulaPais, PatríciaMarques, Inêsinfo:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2023-08-03T02:57:58Zoai:ojs.revistas.rcaap.pt:article/17189Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T20:25:31.213499Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse
dc.title.none.fl_str_mv Guttate Psoriasis: A Case Report
title Guttate Psoriasis: A Case Report
spellingShingle Guttate Psoriasis: A Case Report
Fonseca, Sara
Images in Pediatrics
title_short Guttate Psoriasis: A Case Report
title_full Guttate Psoriasis: A Case Report
title_fullStr Guttate Psoriasis: A Case Report
title_full_unstemmed Guttate Psoriasis: A Case Report
title_sort Guttate Psoriasis: A Case Report
author Fonseca, Sara
author_facet Fonseca, Sara
Pereira, Ana Paula
Pais, Patrícia
Marques, Inês
author_role author
author2 Pereira, Ana Paula
Pais, Patrícia
Marques, Inês
author2_role author
author
author
dc.contributor.author.fl_str_mv Fonseca, Sara
Pereira, Ana Paula
Pais, Patrícia
Marques, Inês
dc.subject.por.fl_str_mv Images in Pediatrics
topic Images in Pediatrics
description Psoriasis is an inflammatory, immune-mediated disease with chronic and recurrent evolution. It results from the interaction between genetic predisposition and endogenous and/or exogenous triggering factors, with an imbalance in the predominantly autoimmune immune response. In guttate psoriasis, which is more prevalent in children and young adults, the association with pharyngitis and/or tonsillitis by group A β-hemolytic Streptococcus is frequent, and the antigens will trigger the immune-mediated response in a field of greater genetic susceptibility, as evidenced by the association with the HLA-cw6 allele. Classical clinical findings include the sudden onset of numerous small papules and erythematous, desquamative plaques, usually located on the trunk, tear drop-like, or often described as droplet psoriasis. In the literature, patients with guttate psoriasis have been reported to develop plaque psoriasis. We describe the case of a 17-year-old girl with a recent history of acute streptococcal tonsillitis who had recourse to the Emergency Department for erythematous, scaly and pruritic micro-papillary lesions initially located in the palms of the hands and later dispersed in the trunk, abdomen and limbs, with appearance of erythematous and scaly plaques on the elbows. No fever. No family history of psoriasis. There were no other changes in physical examination. Based on the hypothesis of guttate psoriasis, he underwent a skin biopsy that corroborated the diagnosis. He started topical treatment, with vitamin D derivative and topical corticosteroid, and phototherapy (ultraviolet B) with favorable evolution. Maintained follow-up in Consultation with evolutionary surveillance for chronicity, namely in the form of plaque psoriasis. Keywords: Guttate Psoriasis, Streptococcal Infections, Teenager
publishDate 2019
dc.date.none.fl_str_mv 2019-11-12
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dc.publisher.none.fl_str_mv Sociedade Portuguesa de Pediatria
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