To the Editor.—
Acute guttate psoriasis (AGP) is one of several well-recognized nonsuppurative sequelae of Streptococcus pyogenes infection.1-3 It is not known whether all strains of S pyogenes have the ability to initiate AGP or whether only a limited number of serotypes are involved, as in the cases of both acute poststreptococcal glomerulonephritis and rheumatic fever. Since the serotypes linked with each of these two diseases are different, the extreme rarity with which they occur simultaneously is to be expected.4 Our inability to find a single report linking either of these two diseases with concurrent AGP suggests that different serotypes may be involved in each of the three conditions. Therefore, we think the following case may be of interest.
Report of a Case.—
The patient was first seen at 16 years of age with classic features of acute poststreptococcal glomerulonephritis after an episode of acute pharyngitis. This was