Treating Guttate Psoriasis

Usually Guttate psoriasis spontaneously disappears in a few weeks without treatment. Simple reassurance and emollients may be sufficient care. As in other conditions, the choice of treatment should be tailored to the individual. For example, applying topical steroids, although effective, could be cumbersome, especially when the eruption is extensive as in most cases of guttate psoriasis.
Antimicrobials: Because of the clear association between guttate psoriasis and streptococcal infection in most cases, obtaining a throat culture for each bout of pharyngitis in patients with a known history of psoriasis and immediately starting the proper antibiotic treatment depending on the culture results are imperative. See Medication below for specific drugs.
Phototherapy: The clearance of guttate lesions can be accelerated by judicious exposure to sunlight or by a short course of either broadband UV-B or narrowband UV-B phototherapy. More resistant cases may benefit from oral psoralen plus exposure to ultraviolet A radiation (PUVA). Aside from the usual mechanisms by which UV light is believed to exert its beneficial effects in psoriasis, a specific fibrosing response to PUVA via increased mast cell activation has been observed in guttate psoriasis and might underlie the mechanism of action behind UV-induced resolution of the lesions. Considering the developments in photomedicine over the last several years, particularly regarding the clinical efficacy of narrowband UV-B phototherapy, treatment with narrowband UV-B might show equally satisfying results.