An 8-year-old boy is brought to the pediatrician by his mother over concerns of a new-onset rash. He is otherwise healthy, though his mother mentions that he was unwell two weeks prior to the rash appearing. On examination, numerous small salmon-pink scaly papules are seen on his trunk and extremities.
Answer: Streptococcal infection
This patient’s presentation is indicative of guttate psoriasis, a skin disorder characterized by the acute onset of numerous, small, discrete papules and plaques on the trunk and extremities that are covered with a fine scale. The condition is associated with a preceding streptococcal infection, often streptococcal pharyngitis, in up to 97% of cases. In most patients, guttate psoriasis spontaneously remits over weeks to months, however in some cases, it can progress to chronic plaque psoriasis.
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