Objectives: Reporting a case of GP patient with a combination treatment of Narrowband Ultraviolet B (NB-UVB), a low dose of oral zinc, and topical corticosteroid
Introduction: Guttate psoriasis (GP) is a distinctive acute form of psoriasis, more frequent in children and young adults. There were several combination treatments in GP, such as methotrexate (MTX) and ultraviolet B (UVB); MTX and psoralen ultraviolet A (PUVA); also UVB and PUVA. Some investigators have correlated zinc levels with the extent of skin lesion.
Materials / method: A-21 years-old Balinese man, skin phototype IV, presented a pruritic, erythematous rash since two weeks ago. He felt swallowing pain before the rash appeared. He had the same skin rash since nine years ago, but there was no history of skin disease or allergy in his family. Physical examination on the chest, back, upper, and lower extremities showed multiple erythematous papules, covered with thin white scales on 20% of body surface area (BSA). Psoriasis Area and Severity Index (PASI) score was 12.3.
Results: There were no abnormalities in laboratory examination; including. Zinc and Anti-Streptolysin O serum levels Throat swab found a commensal bacteria. Dermoscopic examination showed diffuse red dotted vessels. The histopathologic result supported GP. He showed PASI score reduction (6.9) after treatment with three-times NB-UVB, zinc tablet 20 mg daily, and desoximetasone 0.25% cream twice daily.
Conclusion: Guarino et al. (2016), reported that 78% of GP patients achieving PASI90 in a mean of 19.9 sessions with maintained response during 18 months without NB-UVB treatment. In this case, the patient was treated with combination NB-UVB, a low dose of oral zinc and corticosteroid cream and showed a reduction of PASI score of 43.9%. This combination treatment can be a treatment modality for GP due to its good response with minimal side effects
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