Efficacy

The reviews did not identify any trials of standard therapies (tar, topical corticosteroids, vitamin D analogues, phototherapy) for guttate psoriasis.

Omega-3 fatty acids

One RCT (n = 21) compared the effects of daily intravenous infusions of lipid-rich emulsions containing either fish-oil-derived omega-3 fatty acids or placebo (omega-6 fatty acids) in hospitalised patients with acute guttate psoriasis. The former produced a rapid beneficial effect (improvement in severity scores of 45-76% over 10 days) not seen in patients receiving omega-6 supplementation (16-25% over 10 days).106 It is not known whether oral supplementation with omega-3 fatty acids would have similar effects, although they have been shown to have a modest effect in chronic plaque psoriasis.

Antibiotic therapy

Despite recommendations in many standard texts that antibiotics should be given to people with recurrent guttate psoriasis, the only RCT examining their use found no evidence of benefit in any patient receiving either of two antibiotic regimens.107

How effective are treatments for guttate psoriasis?

Tonsillectomy

No RCT examining the effects of tonsillectomy on recurrence or persistence of guttate psoriasis was found.

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