Summary. Conditions to consider in the differential diagnosis of guttate psoriasis 1,2; Disease. - 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 The PASI score is the ‘Psoriasis Area and Severity Index’, and is mainly used for evaluating the effect of interventions in clinical trials. 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. Differential diagnosis. Usually starts with a single plaque (‘herald patch’), with colour from salmon to erythematous, followed by a generalised eruption after several days 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. 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: These entities can be differentiated from guttate psoriasis based on history and physical examination with skin biopsy when necessary. Nummular eczema, tinea corporis, cutaneous T-cell lymphoma, atopic dermatitis, contact dermatitis and yeast infections in skin folds can all be confused with psoriasis. 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. 2. The pustules are not contagious but are the result of sudden and extreme autoimmune inflammation. It may be precipitated by a streptococcal infection 2-4 weeks prior to the lesions appearing. Psoriasis is a common chronic inflammatory skin disorder affecting individuals with an underlying genetic predisposition. Scalp 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. 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) Psoriasis () Definition (MEDLINEPLUS) Psoriasis is a skin disease that causes itchy or sore patches of thick, red skin with silvery scales. 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. In a majority of patients it is a self limiting condition (2). The clinical features include: … It tends to affect children and young adults and has a good chance of spontaneously clearing. 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. Enzo Errichetti, Giuseppe Stinco, Dermoscopy in differential diagnosis of palmar psoriasis and chronic hand eczema, The Journal of Dermatology, 10.1111/1346-8138.13142, 43, 4, … Skin biopsy is more informative. Guttate psoriasis is characterised by multiple small 'tear drop' lesions that tend to affect most of the body. 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 . 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. The diagnosis of psoriasis can be made by clinical observation without laboratory tests in most cases. These variants to 6 can be differentiated from the common plaque type by morphology. Differential diagnosis ... Guttate psoriasis is more common in children and adolescents. Epidemiology. Differential diagnosis Discoid eczema . Psoriasis is a skin disease that causes itchy or sore patches of thick, red skin with silvery scales. Diagnosis of Guttate Psoriasis Diagnostic considerations. The second most common form is localized pustular psoriasis of the palms and soles. 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. Von Zumbusch psoriasis, also known as acute generalized pustular psoriasis, is a rare type of psoriasis characterized by white, pus-filled blisters (pustules). Plaque psoriasis may be confused with: Discoid dermatitis (more itch, vesicles, dry rather than plate-scale) Chronic plaque psoriasis (including scalp psoriasis, flexural psoriasis, and facial psoriasis) is the most common form, affecting 80–90% of people with psoriasis. Psoriasis: Epidemiology, clinical manifestations, and diagnosis View in Chinese … with pre-existing psoriasis. 1 Below is a review and update on the assessment, diagnosis, and treatment of psoriasis. Viral exanthema should also be considered. The differential diagnosis includes pityriasis rosacea, tinea corporis, secondary syphilis, pityriasis lichenoides chronica, nummular dermatitis, and drug eruptions. Guttate psoriasis is a skin condition in which small, droplet-shaped, red patches appear on the arms, legs, scalp, and trunk. Pityriasis rosea. Psoriasis is a chronic inflammatory disease that affects primarily the skin and joints. In this study, PLC and GP lesions were examined using dermoscopy, and the significance of s … Evaluation and differential diagnosis.Less common variants of psoriasis include inverse psoriasis, pustu-lar psoriasis, guttate psoriasis, erythrodermic psoriasis, and annular psoriasis (Figures 3). Table 1. Misdiagnosis of Guttate psoriasis including hidden diseases, diagnosis mistakes, alternative diagnoses, differential diagnoses, and misdiagnosis. Guttate psoriasis is a form of psoriasis that often appears in the wake of strep throat and other similar infections. 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 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). Differentiating features. Background: Psoriasis is an inflammatory skin disease presenting with erythematous and desquamative plaques with sharply demarcated margins, usually localized on extensor surface areas. 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. The blood tests are aimed at determining the non-specific signs of inflammation (leukocytosis, an increase of erythrocyte sedimentation rate, rheumatoid factor). The rash comes on very quickly and may follow a streptococcal infection of the throat. It is calculated as follows: Differential diagnosis. The differential diagnoses of guttate psoriasis include tinea corporis, secondary syphilis, nummular eczema, and pityriasis rosea. Guttate psoriasis often follows acute group B haemolytic streptococcal pharyngitis in persons genetically predisposed to psoriasis. Important for differential diagnosis, the uniform distribution of the red dots within the lesion represents the dermoscopic hallmark of psoriasis. It accounts for 2% of the total cases of psoriasis (1). Guttate psoriasis (also called eruptive psoriasis) ... which are usually enough for the differential diagnosis. 54 Differential diagnoses include atopic der- 3 Skin scrapings and nail clippings may be requiredto exclude tinea. The disease manifests following exposure to various triggers (e.g., infection, medication). There is a strong association between recent infection (usually streptococcal pharyngitis) and guttate psoriasis. 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