Which clinical type of psoriasis is characterized by small, discrete papules and plaques with a sudden onset, often triggered by streptococcal infection?

Explanation

## Guttate Psoriasis **Key Point:** Guttate psoriasis is a distinct clinical variant characterized by: - **Sudden onset** of numerous small (1–10 mm), discrete papules and plaques - **"Raindrop" or "teardrop" appearance** (hence the name: *gutta* = drop) - **Strong association with streptococcal pharyngitis** (β-hemolytic streptococci) - Typically occurs **2–3 weeks after streptococcal infection** ### Epidemiology & Triggers | Feature | Detail | |---------|--------| | Age of onset | Often in children and young adults (< 40 years) | | Trigger | Group A Streptococcus pharyngitis (most common) | | Latency | 2–3 weeks post-infection | | Course | May resolve spontaneously or progress to chronic plaque psoriasis | | Prevalence | Accounts for ~10% of all psoriasis cases | **High-Yield:** The **streptococcal trigger** is the key distinguishing feature. Throat culture or ASO titer elevation may support the diagnosis. Treatment of the underlying streptococcal infection may help prevent recurrence. **Mnemonic:** **"GUTTATE = Guttural (throat) + Acute + Tiny papules"** — remember the streptococcal pharyngitis link. **Clinical Pearl:** Guttate psoriasis may be the first presentation of psoriasis in a patient with no prior family history, and recognition of the streptococcal trigger is important for counseling and potential prevention of recurrence.