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Journal of the American Academy of Dermatology
Volume 42, n° 5P2
pages 885-887 (mai 2000)
Doi : 10.1016/S0190-9622(00)90263-9
Guttate psoriasis triggered by perianal streptococcal dermatitis in a four-year-old boy

Rudolf A. Herbst, MD, Olliver Hoch, MD, Alexander Kapp, MD, PhD, Jürgen Weiss, MD
Department of Dermatology and Allergology, Hannover Medical University. Hannover, Germany 


Perianal streptococcal dermatitis (PSD) is a superficial bacterial infection usually with group A beta-hemolytic streptococci. PSD is often misdiagnosed for long periods and patients are subjected to treatments for a variety of differential diagnoses without success. We report a 4-year-old boy with PSD who presented to our clinic with guttate psoriasis for 2 reasons: first, to make dermatologists aware of PSD and second, to emphasize the necessity to examine patients, particularly pediatric patients, with guttate psoriasis very thoroughly and swab both the pharynx and perianal and/or perigenital areas even when they are, or seem to be, asymptomatic for bacterial infections. Once PSD has been diagnosed, systemic antibiotic therapy with penicillin, erythromycin, roxithromycin, or azithromycin (probably augmented by topical mupirocin ointment) should be the treatment of choice. Therapy should be monitored by posttreatment perianal and throat swabs as well as a urine analysis to monitor for poststreptococcal glomerulonephritis. (J Am Acad Dermatol 2000;42:885-7.)

The full text of this article is available in PDF format.

 This supplement is made possible through an educational grant from Ortho Dermatological to the American Academy of Dermatology.
 Reprint requests: Rudolf A. Herbst, MD, Department of Dermatology and Allergology, Hannover Medical University, Ricklinger Strasse 5, D 30449 Hannover, Germany. E-mail: .

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