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For each of the ten cases, study the image(s) and then answer the questions. You can click on the image to view a larger version if required.
Each case should take approximately 2 minutes to complete. There is a list of suggested further reading material at the end of the quiz.
When you finish the quiz, you can download a certificate.
Describe the rash in the image displayed.
The image shows profuse scaly erythematous papules and small plaques on the back and upper limbs.
What is this skin condition?
This is acute guttate psoriasis affecting an adult woman.
What is the cause?
Guttate psoriasis tends to start very abruptly a week or two after streptococcal pharyngitis. However, streptococcal infection is not confirmed in every case.
What are its clinical features?
Guttate psoriasis presents with numerous small erythematous plaques on the whole body, often most severe on the trunk. Guttate psoriasis does not usually cause much in the way of symptoms, but the plaques may sting, burn or itch intensely. The patient may also be fairly alarmed!
The patient is generally quite well at the time of the rash.
What investigations should be performed?
In typical cases no specific investigations are required, as they do not change management. However, throat swab may be worthwhile, and occasionally a skin biopsy is performed in case of clinical doubt.
What is the recommended treatment?
Antibiotics should only be prescribed if persisting streptococci are cultured from the throat.
Management depends on severity and symptoms and may include:
In many cases, the psoriasis completely resolves within 3-4 months. However, it may lead to chronic plaque psoriasis or recur next time the patient suffers a sore throat.