Guttate Psoriasis and Seasonal Infections: A Guide to Sudden Psoriasis Flares

What Is Guttate Psoriasis?

“Guttate” comes from the Latin word for “drop,” which perfectly describes the rash’s tiny, raindrop-shaped spots. These small pink or red bumps usually appear on the trunk, arms, legs, and sometimes the scalp, often with fine, silvery-white scaling.

Unlike chronic plaque psoriasis, guttate psoriasis tends to come on suddenly and spread quickly — most often two to three weeks after a strep throat or upper respiratory infection.

What Causes It?

Guttate psoriasis happens when the immune system overreacts after an infection, most commonly streptococcal pharyngitis (strep throat).The immune response triggers inflammation in the skin, leading to the development of these drop-like spots.

While anyone can get guttate psoriasis, it’s most common in children, teens, and young adults under 30, especially those with a family history of psoriasis.

Other possible triggers include:

• Certain viral infections (like chickenpox)

• Skin injury or irritation

• Certain medications

• Significant stress

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What Does It Look and Feel Like?

Typical signs include:

• Dozens to hundreds of small, scaly red or pink spots

• Areas often include the trunk, upper arms, and thighs

• Sometimes mild itching

• No scarring, though temporary pigment changes (lighter or darker spots) can remain after healing

  
  

If your guttate psoriasis was triggered by strep throat, you might also notice sore throat or redness in the mouth or perianal area.

How Is It Diagnosed?

Diagnosis is often made by looking at the skin and reviewing your recent medical history. Sometimes, your provider may recommend:

• A throat culture or blood test for strep infection (anti-streptolysin O or anti-DNase B titers)

• A urinalysis if there’s concern for a post-strep complication like glomerulonephritis

  
  

How Is Guttate Psoriasis Treated?

Treatment depends on how widespread and severe the rash is — and whether there’s an active strep infection.

1. Treat the infection:

If strep throat is still present, antibiotics like amoxicillin or penicillin may be prescribed. Treating the infection helps prevent future flares.

2. Soothe the skin:

For mild cases, topical treatments such as:

• Mid- to high-potency corticosteroids (like triamcinolone or clobetasol)

• Vitamin D analogs (like calcipotriene)

• Gentle skin hydration and emollients

  
  

3. Light therapy (phototherapy):

For more widespread cases, narrow-band UVB therapy several times a week can be very effective. Natural sunlight in short, safe intervals may also help.

4. Systemic treatments:

If guttate psoriasis is severe or persistent, systemic medications may be used under dermatology supervision.

What to Expect

The good news: Guttate psoriasis often clears within weeks to a few months, especially in children. Some adults, however, may go on to develop chronic plaque psoriasis, so ongoing skin care and monitoring are important.

To help prevent future flares:

• Promptly treat sore throats or respiratory infections

• Avoid scratching or irritating the skin (which can worsen lesions)

• Keep your skin moisturized

• Manage stress and get plenty of rest

  
  

When to See a Dermatology Provider

If you notice a sudden rash following a sore throat or cold, or if your psoriasis symptoms are spreading quickly, it’s best to schedule a dermatology visit. Virtual visits through Dermatolo-G make it easy to get a professional diagnosis and treatment plan — right from home.

Bottom line: Guttate psoriasis can look alarming, but it’s often a temporary and very treatable condition. With proper evaluation and targeted care, most people see their skin return to normal within a few months.