Causes
Guttate Psoriasis
Infection as a Primary Trigger
The onset of guttate psoriasis is most commonly linked to streptococcal infections, particularly those involving the throat, such as tonsillitis. These bacterial infections prompt the immune system to respond aggressively, not just against the pathogens, but also against the body’s own cells, including those in the skin. This immune reaction can lead to the rapid development of numerous guttate lesions.
Viral Infections
Beyond bacterial infections, viral infections have also been shown to trigger guttate psoriasis. Notably, cases have been reported following infections with the SARS-CoV-2 virus (responsible for COVID-19) and enteroviruses like the coxsackievirus. These viral agents can disrupt the normal immune response, leading to a similar proliferation of T-cells directed against skin cells, thereby causing or exacerbating psoriasis outbreaks.
Genetic Susceptibility
Guttate psoriasis often occurs in individuals with a family history of psoriasis, indicating a strong genetic component. Specific genes associated with the immune system’s functioning, particularly those involved in the inflammatory process, may increase susceptibility to developing psoriasis when combined with environmental triggers.
Environmental and Lifestyle Factors
Several non-infectious factors can also trigger or exacerbate guttate psoriasis,including:
Medications
Certain medications, such as beta-blockers and antimalarials, are known to precipitate or worsen symptoms of psoriasis.
Physical Injury
Physical trauma to the skin, known as the Koebner phenomenon, can induce psoriasis lesions at the site of injury.
Stress
Psychological stress is a well-documented trigger for psoriasis flare-ups due to its impact on immune function and inflammation.
Other Infections
Upper respiratory infections, sinus infections, and even asymptomatic strep infections can prompt or aggravate guttate psoriasis.
Managing Triggers
Understanding and managing these triggers form a critical part of treating guttate psoriasis. Patients are often advised to maintain a healthy lifestyle, manage stress effectively, and avoid medications known to trigger psoriasis. Regular check-ups and prompt treatment of infections can also help manage and reduce the frequency of flare-ups.
