Jenny's Story Living with Guttate Psoriasis

By: Jenny She, Baylor College of Medicine, M.D. Candidate Class of 2028
The rash appeared ruthlessly, without warning.
It was June 2024, and the beginning of what I thought would be my most exciting summer yet. I had just graduated college and was looking forward to a few precious months before medical school. I was determined to savor every moment before diving into a rigorous academic life.
It started innocently—a couple of small, red dots on my chest. I assumed they were just irritation from my sticky, strapless bra. I had seen similar rashes before and thought little of it. But I was very wrong.
Over the next couple of days, the red dots spread, growing itchy and scaly. They crept down my torso, across my back, and eventually to my arms and legs. Soon, new spots appeared, larger and ring-like, covering nearly every inch of my body—from my collarbone to my feet. I was terrified.
I panicked, my mind racing with possibilities. Was this an allergic reaction? Had my body finally reacted to years of wearing that adhesive bra? Could this be a severe, full-body response to contact dermatitis? Each morning, I hoped it would disappear, but the rash only worsened. Deep down, I knew this was something much more serious.
Searching for a Diagnosis
I managed to see a dermatologist, who initially diagnosed me with pityriasis rosea, reasoning that I had experienced it years ago. However, after hearing my history, she considered an id reaction—a secondary skin eruption triggered by inflammation, like allergic contact dermatitis.
She recommended I avoid the adhesive bra and any lotions I had been using, and she suggested starting with over-the-counter hydrocortisone, escalating to triamcinolone if needed.
The next few weeks were grueling. Each night, I slathered triamcinolone over every inch of my body, leaving me an oily, uncomfortable mess. The itchiness was unbearable, but I resisted scratching, fearful of leaving scars. I woke up each day hoping to find clear skin in the mirror, but the rash only grew more concentrated and widespread.
By July, I saw another dermatologist in person. After examining my skin and hearing my story, she suspected guttate psoriasis. She explained that guttate psoriasis—a type triggered by infections like strep throat—often presents as “raindrop-shaped” red patches with faint halos. She ordered a blood test for anti-streptolysin O titer (ASOT) to confirm.
When the result came back positive, I felt a mix of relief and dread. Finally, I had a diagnosis. But now I faced new questions: What was guttate psoriasis? Would this ever go away?
The Emotional Toll
I turned to the internet for answers and was overwhelmed by worst-case scenarios. Stories of guttate psoriasis progressing to chronic psoriasis filled my mind. I learned that one-third of cases become chronic, leaving patients with lifelong skin issues.
Despair consumed me. I feared I’d need to cover myself in long sleeves and pants, even in Houston’s sweltering heat, to avoid uncomfortable stares.
The life I had envisioned—a new chapter in medical school filled with confidence, friendships, and self-expression—seemed to vanish. The rash wasn’t just physical; it eroded my confidence and sense of self.
It became clear that something society often dismisses as “just a rash” could profoundly affect a person’s life. Skin conditions aren’t superficial. They affect how we interact with the world, how we see ourselves, and how others perceive us.
A Glimmer of Hope
After my diagnosis, my dermatologist prescribed dicloxacillin, an antibiotic, along with continued use of triamcinolone. While the antibiotic caused severe nausea and heartburn, my rash barely improved.
Frustrated, I began researching other treatments—UVB phototherapy, topical tar, even methotrexate. My mental health plummeted. At a hair appointment, my stylist pointed out plaques on my scalp and significant hair shedding.
I felt defeated. The disease was stripping away everything society deemed essential to “feeling beautiful”—clear skin, healthy hair.
In August, I sought another opinion. This dermatologist prescribed penicillin three times daily for a week, paired with a stronger corticosteroid, Clobetasol, for up to two weeks.
It was a turning point. Within two weeks, my rash had faded significantly. My doctor explained that penicillin, an “ancient” drug, targeted the strep infection that had triggered my psoriasis.
Moving Forward
Six months later, my rash is nearly gone. Though faint red marks reappear after hot showers, they are no longer visible day-to-day.
This experience profoundly changed me. It taught me to appreciate health as a privilege and to empathize deeply with others facing visible conditions. Society may dismiss skin conditions as minor, but they can profoundly affect a person’s life and mental health.
I’m deeply grateful for the clinicians who treated me with care and attention. Their willingness to listen, examine every detail, and validate my emotions gave me hope.
As a future physician, I’m committed to offering the same empathy and care to my patients. I want them to feel heard, understood, and supported.
Guttate psoriasis tested my resilience, but it also gave me perspective. It taught me that even in pain, there is room for growth, gratitude, and strength.