Multiple Small Plaques of Psoriasis

A 56-year-old man sought medical attention because of the sudden appearance of a rash on the trunk and extremities. Immediately before presentation, he had experienced a severe upper respiratory tract infection, which included pharyngitis.

Key point: The patient’s eruption largely consists of multiple small plaques of psoriasis. There was a notable paucity of large plaques. Scalp and nails were normal. This is a good example of guttate (“drop-like”) psoriasis.

Treatment: The patient responded well to topical mid-potency topical corticosteroid application combined with narrow band UVB phototherapy.

Note: Guttate psoriasis often appears in conjunction with an upper respiratory tract infection, particularly streptococcal tonsillitis. This phenomenon is more common in children.