Guttate Psoriasis Can Present With Psoriatic Arthritis after Urinary Tract Infection: Case Report
DOI:
https://doi.org/10.17140/DRMTOJ-1-113Keywords:
Psoriasis, Psoriatic arthritis, Guttate, Urinary tract infectionAbstract
Introduction: Psoriasis and psoriatic arthritis (PsA) are serious, poorly understood, diseases.
As many as 10-30% of psoriasis patients develop an inflammatory arthritis termed psoriatic
arthritis which is progressive and leads to destruction of the joints if it is not treated assertively.
Several triggering factors may elicit or aggravate the expression of psoriasis, of which focal
infections is a well-established triggering factor, in particular infections of the upper respiratory
tract. Guttate (eruptive) psoriasis, known to have a better prognosis than other types of psoriasis
with rapid involution and longer remission, but its clinical course has barely been studied. We
are presenting a case of guttate psoriasis with sever onset and association with nail psoriasis,
scalp psoriasis and psoriatic arthritis, all which started unexpectedly after urinary tract infection
Case Presentation: We are presenting a young woman of 32-years-old who presented to our
service with a typical guttate psoriasis lesion after urinary tract infection. Her guttate psoriasis
exhibited unusual sever course with associated onset of nails psoriasis, scalp psoriasis, conjunctivitis
and psoriatic arthritis. All the symptoms started few days after urinary infection
symptoms.
Conclusion: Guttate psoriasis that occurs after urinary tract infection, may exhibit sever onset
and rapid progression to psoriatic arthritis.
References
Nograles KE, Brasington RD, Bowcock AM. New insights into the pathogenesis and genetics of psoriatic arthritis. Nat Clin Pract Rheumatol. 2009; 5(2): 83-91. doi: 10.1038/ncprheum0987
Chandran V, Raychaudhuri SP. Geoepidemiology and envi-ronmental factors of psoriasis and psoriatic arthritis. J Autoim-mun. 2010; 34(3): 314-321. doi: 10.1016/j.jaut.2009.12.001
Ko HC, Jwa SW, Song M, Kim MB, Kwon KS. Clinical course of guttate psoriasis: Long-term follow-up study. J Dermatol. 2010. 37(10): 894-899. doi: 10.1111/j.1346-8138.2010.00871.x
Chalmers RJ, O’Sullivan T, Owen CM, Griffiths CE. A sys-tematic review of treatments for guttate psoriasis. Br J Dermatol. 2001; 145(6): 891-894. doi: 10.1046/j.1365-2133.2001.04505.x
Potok O, Prajapati V, Barankin B. Can you identify this condi-tion? Can Fam Physician. 2011; 57(1): 56-57.
Fitzpatrick TB, Johnson R, Wolf K, Suurmond D. Color Atlas and Synopsis of Clinical Dermatology: Common and Serious Diseases. 4th ed. New York, NY, USA: McGraw Hill; 2001.
Martin BA, Chalmers RJ, Telfer NR. How great is the risk of further psoriasis following a single episode of acute guttate psoriasis? Arch Dermatol. 1996; 132(6): 717-718. doi: 10.1001/ archderm.1996.03890300147032
Ayala F. Clinical presentation of psoriasis. Reumatismo. 2007; 59(Suppl 1): 40-45. doi: 10.4081/reumatismo.2007.1s.40
Fry L, Baker BS. Triggering psoriasis: The role of infections and medications. Clin Dermatol. 2007; 25(6): 606-615.
Buslau M, Menzel I, Holzmann H. Fungal flora of human faeces in psoriasis and atopic dermatitis. Mycoses. 1990; 33(2): 90-94. Web site. http://europepmc.org/abstract/med/2191222. Accessed September 16, 2016.
Favre M, Orth G, Majewski S, Baloul S, Pura A, Jablonska S. Psoriasis: A possible reservoir for human papillomavirus type 5, the virus associated with skin carcinomas of epidermodys-plasia verruciformis. J Invest Dermatol. 1998; 110(4): 311-317. 10.1046/j.1523-1747.1998.00164.x
Gudjonsson JE, Thorarinsson AM, Sigurgeirsson B, Kris-tinsson KG, Valdimarsson H. Streptococcal throat infections and exacerbation of chronic plaque psoriasis: A prospective study. Br J Dermatol. 2003; 149(3): 530-534. doi: 10.1046/j.1365- 2133.2003.05552.x
Telfer NR, Chalmers RJ, Whale K, Colman G. The role of streptococcal infection in the initiation of guttate psoria-sis. Arch Dermatol. 1992; 128(1): 39-42. doi: 10.1001/arch-derm.1992.01680110049004
Raza N, Usman M, Hameed A. Chronic plaque psoriasis: Streptococcus pyogenes throat carriage rate and the therapeutic response to oral antibiotics in comparison with oral methotrex-ate. J Coll Physicians Surg Pak. 2007; 17(12): 717-720. doi: 12.2007/JCPSP.717720
Wang GL, Li XY, Wang MY, et al. Cell-wall-deficient bacte-ria: A major etiological factor for psoriasis? Chin Med J (Engl). 2009. 122(24): 3011-306. Web site. http://www.medicinabiomo-lecular.com.br/biblioteca/pdfs/Doencas/do-1704.pdf. Accessed September 16, 2016.
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