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DrRussMD
DrRussMD, Board Certified MD
Category: Medical
Satisfied Customers: 64938
Experience:  Board certified Internal medicine and Integrative medicine. Many years of experience all areas.
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My daughter has been diagnosed with Guttates psoriasis following

Resolved Question:

My daughter has been diagnosed with Guttate's psoriasis following a Strep throat 3 weeks ago. The rash started off on her trunk but is spreading rapidly. The GP has given her coal tar bathing treatments and also a topical moisturising cream. Will taking antihistamines help. Can you tell me what the prognosis is more about it as I have never heard of this before. Would it help if I tried to get her referred for PUVA treatment. (I don't know what the modern equivalent is, I used to be a physiotherapist) Is this a case for a dermatologist or immunologist?
Submitted: 3 years ago.
Category: Medical
Expert:  Dr. Robert replied 3 years ago.
Hello,
Welcome back to justanswer.com and thank you for your question.

I will do whatever I can to help answer your questions .First I need a little more information-

To which body parts it has spreaded or what parts of her body are affected now?
Is there red raised bumps?
Itching?
Any test done so far?

Kind Regards,
Dr. Robert




Expert:  DrRussMD replied 3 years ago.
Hello from JA

Your questions are very clear.
I am a board certified internal medicine doctor and can provide you with answers and answers to any follow up questions.
Anti histamines are not particularly useful in this condition.
Coal tar is effective but rather old fashioned. Topical steroid cream is really more first line.
Also light therapy should be considered as this is often effective, is not a drug and is non toxic.
Only in severe cases are oral medications/immune altering medications needed.

Yes you are correct to ask about PUVA treatment.

Coal tar is relatively safe but does have some potential toxicity.

This is in fact a case for a dermatologist and rheumatologist if systemic symptoms develop.

Please let me know if you have further questions.
Use reply as needed.
Please do not forget a positive rating.

Customer: replied 3 years ago.

One of the questions I asked was what the prognosis was. She is very itchy and the rash is spreading. It covers her trunk. Will it extend to her face, how long do outbreaks usually last. Is it possible to cure and if not will she always have the rash? Which treatment is best to help with the discomfort of the itching.What is the cause and mechanism of the rash? What are the possible systemic symptoms of which you speak. Is this autoimmune? I requested a high level detailed answer.( I am a retired physio.)


Many Thanks

Expert:  DrRussMD replied 3 years ago.
It is possible to put this into complete remission. That is why there is a drug progression in terms of treatment.

Yes this is autoimmune but it might never progress beyond this. On the other hand, psoriasis can lead to arthritis, as an autoimmune disease, which is why early control is needed.

The mechanism of course is the body attacking itself.

Guttate is the limited form, so this is actually a positive.

The other good news of this, is that this form tends to resolve, or even resolve spontaneously, even without treatment.

Here is one excellent overview of treatment

http://emedicine.medscape.com/article/1107850-overview#aw2aab6c12
DrRussMD, Board Certified MD
Category: Medical
Satisfied Customers: 64938
Experience: Board certified Internal medicine and Integrative medicine. Many years of experience all areas.
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