To the Editor.—
The influence of genetic factors in the expression of psoriasis is widely accepted. The association between acute guttate psoriasis (AGP) and group A β-hemolytic streptococci infection is also well known. We present three cases of AGP occurring in one family in a 2-month period. These cases demonstrate this combination of genetic and environmental influences in psoriasis.
Report of Cases.—
A 4-year-old white girl was seen in May 1989 with a 2-month history of generalized guttate psoriasis. In late February 1989, she received amoxicillin therapy for an upper respiratory infection and impetiginous lesions around her nose. Three weeks later, she developed a generalized eruption typical of guttate psoriasis. Her 26-year-old mother had also developed AGP 2 weeks following culture-proven group A β-hemolytic streptococcal pharyngitis in early January 1989. The child's 48-year-old maternal grandmother (who visited from Colorado in late December 1988 and early January 1989) developed AGP 1
Bolton GG, Daniel CR. A Family Outbreak of Acute Guttate Psoriasis. Arch Dermatol. 1990;126(11):1523-1524. doi:10.1001/archderm.1990.01670350139034