Medications for Guttate Psoriasis
Doctors may use antibiotics when the guttate psoriasis is related to a streptococcal infection. They may choose an antibiotic that will act on a wide range of bacteria. Always tell your doctor what drugs you are currently taking because of the possibility of drug reactions.
Erythromycin(EES, E-Mycin, Ery-Tab) -- Reduces inflammation and is used to treat bacterial infections. The usual dosing is one to three tablets per day by mouth for about seven to 14 days. People with allergies to erythromycin or who have liver problems should not take this drug. Discontinue use if nausea, vomiting, fatigue, intestinal cramping, or fever occurs.
Penicillin VK (Veetids, Beepen-VK) -- Is used to treat bacterial infections. The usual dosing is one or two tablets per day by mouth for about 10 to 14 days. People with allergies to penicillin should not take this drug. Caution is taken with the dosing of this drug in those who have reduced kidney function.
Rifampin (Rifadin, Rimactane) -- Recommended for resistant cases of streptococcal infection. If the doctor thinks it is possible that the infection will last a long time and you may become a chronic carrier of the bacteria, he or she may prescribe this drug. Rifampin is usually given in addition to either erythromycin or penicillin. The drug is taken by mouth over the course of five days.
You should be aware of possible allergic reactions to any antibiotic used, especially penicillin. Stop taking the drug if an allergic reaction is suspected. Patients who are sensitive to penicillin generally do well on erythromycin. Cephalosporin is an antibiotic that can also be used for streptococcal infections, but some cross-sensitivity with penicillins has been documented.
Surgery for Guttate Psoriasis
Although unproven by large controlled studies, a tonsillectomy (procedure to remove the tonsils) for patients with chronic guttate psoriasis due to streptococcal infections in the tonsils may be helpful.
Preventing Guttate Psoriasis
Guttate psoriasis may not be preventable. However, complications or further flare-ups may be reduced by avoiding anything that triggers a psoriasis outbreak. For example, anyone with psoriasis should try to minimize all forms of skin trauma, such as scratching or vigorous rubbing, which may lead to new psoriatic lesions on previously unaffected areas. This is known as the Koebner phenomenon.
The association between streptococcal infections and guttate psoriasis cannot be overemphasized.
- Early detection and treatment of such infections may prevent an acute flare-up of the skin disease. Tonsil swabs should be obtained and cultured in patients who are susceptible to psoriasis and have a sore throat.
- Some doctors advocate early antibiotic therapy of any sore throat in individuals who are susceptible.
Outlook for Guttate Psoriasis
- Although guttate psoriasis usually clears up within a few weeks, it may also be the first step to chronic plaque psoriasis.
- Like other forms of psoriasis, guttate psoriasis has the tendency to improve during the summer and worsen during the winter. Once the outbreak clears, many patients with acute guttate psoriasis usually have limited or no evidence of psoriasis for prolonged periods.