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January 1983

Psoriasis, Glomerulonephritis, and Rheumatic Fever

Arch Dermatol. 1983;119(1):3. doi:10.1001/archderm.1983.01650250007003

To the Editor.—  The patient of Chalmers and Ive described in the Archives article entitled "Is Acute Guttate Psoriasis With Renal Disease a Rarity?" (1982;118:141) who had both glomerulonephritis and psoriasis may truly be unique, as they suggest.Before my present position in dermatology, I worked for five years on a large, well-known clinical study of patients with poststreptococcal glomerulonephritis and rheumatic fever.1,2 Poststreptococcal acute guttate psoriasis was an unknown entity among that population. As Chalmers and Ive suggest, this indicates a uniqueness either in strains or in immunologic response.The streptococcal strains associated with poststreptococcal acute guttate psoriasis in this community have been M type 1, T type 1. This is a common isolate in this area and has been associated with both glomerulonephritis and rheumatic fever.2-4 If this trend persists, then the streptococcal strains that bring about flares of psoriasis are not uniquely different from those