Guttate psoriasis in Child
While guttate psoriasis may occur in any age group, it is most common in children and young adults under the age of 30. The prognosis in children is typically better than in adults, with many children spontaneously clearing within several weeks to months. Nevertheless, some patients will go on to develop chronic psoriatic disease several years later.
L40.4 – Guttate psoriasis
37042000 – Guttate psoriasis
Differential Diagnosis & Pitfalls
- Nummular dermatitis – Intensely pruritic, coin-shaped lesions almost exclusively seen on the extremities.
- Tinea corporis – Usually fewer isolated lesions. Check potassium hydroxide (KOH) prep.
- Tinea versicolor – Less scale and less inflammatory. KOH-positive.
- Pityriasis rosea – Look for a herald patch, collarette of scale, and orientation of lesions (fir-tree pattern in skin tension lines).
- Small plaque parapsoriasis – More common in older adults; chronic asymptomatic patches.
- Pityriasis lichenoides chronica – Biopsy will assist in differentiating from guttate psoriasis, predominantly CD8+ T-cell infiltrate.
- Lymphomatoid papulosis – Biopsy will assist in differentiating from guttate psoriasis, predominantly CD30+ T-cell infiltrate. Generally presents as recurrent crops of papules. Uncommon in children.
- Psoriasiform drug eruption – Ask about medication history.
- Viral exanthem – Usually less scaly.
- Chronic papular atopic dermatitis
- Pityriasis lichenoides et varioliformis acuta (PLEVA) presents with recurrent crops of crusted, vesicular, or pustular lesions.