A Case of Guttate Psoriasis Associated with Perianal Streptococcal Dermatitis.

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  • こう囲溶連菌性皮膚炎（Ｐｅｒｉａｎａｌ　Ｓｔｒｅｐｔｏｃｏｃｃａｌ　Ｄｅｒｍａｔｉｔｉｓ）を伴った滴状乾せん

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A 60-year-old Japanese woman with az three-year history of red scaly eruptions on her trunk and scalp had been repeatedly treated by topical corticosteroid application. The patient failed to improve and, when initially seen by us, demonstrated both small psoriasiform lesions on her trunk and scalp, as well as perianal erythema. A swab was used to obtain a perianal specimen and then was tested for group A streptococcal antigen by a direct antigen-testing procedure. The antigen study was positive. The throat swab culture was negative, and laboratory investigations such as ASLO, ASK and ASP were all within the normal limits. A skin biopy specimen showed changes compatible with psoriasis. Based on these data, we diagnosed guttate psoriasis associated with perianal streptococcal dermatitis. The patient was treated with amaxicillin for ten days. At follow-up she had still demonstrated some eruptions, she was therefore treated with roxithromycin for 4 weeks, after which the perianal erythema disappeared completely and guttate psoriasis was observed to decrease.

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