- Psoriasis plaques are well-defined; eczema tends to be flatter with less well-defined edges.
- Eczema typically occurs on locations atypical for psoriasis, such as the front of elbows or behind the knees. Psoriasis is most often found on the outside of knees and elbows, the scalp, the lower back, the face, the palms and soles of feet. It also can show up in other places, such as fingernails, toenails, the genitals and inside the mouth.
Types of PsoriasisPsoriasis appears in a variety of forms with distinct characteristics. Typically, an individual has only one type of psoriasis at a time. Generally, one type of psoriasis will clear and another form of psoriasis will appear in response to a trigger.
Psoriasis on Specific LocationsPsoriasis can show up anywhere—on the eyelids, ears, mouth and lips, skin folds, hands and feet, and nails. The skin at each of these sites is different and requires different treatments. In addition, psoriasis can vary widely among individuals and in its response to treatment. Light therapy or topical treatments are often used when psoriasis is limited to a specific part of the body. However, doctors may prescribe oral or injectable drugs if the psoriasis greatly affects a person's quality of life. Effective treatments are available, no matter where your psoriasis is located.
Scalp psoriasis can be very mild, with slight, fine scaling. It can also be very severe with thick, crusted plaques covering the entire scalp. Psoriasis can extend beyond the hairline onto the forehead, the back of the neck and around the ears. Learn about treating scalp psoriasis »
Psoriasis can be mild, moderate or severe
About four out of five people with psoriasis have what is considered mild psoriasis, and about one out of five have moderate to severe psoriasis. These categories are useful for selecting which treatments may be most appropriate for each individual.
However, the severity of psoriasis is also measured by how psoriasis affects a person's quality of life. For example, psoriasis can have a serious impact on one’s daily activities even if it involves a small area, such as the palms of the hands or soles of the feet.
Generally, for those people who have mild psoriasis—isolated patches on the knees, elbows, scalp and hands and feet—topical treatments, including moisturizers, and over-the-counter and prescription creams, ointments and shampoos are usually sufficient to control the plaques.
Many successful psoriasis alternative therapies are also available and widely used with beneficial effects by people with mild psoriasis. Find out as much as you can about all the options available to you, and then learn what works best for your own mild psoriasis.
Treating moderate to severe psoriasis usually involves a combination of treatment strategies. Besides topical treatments, your doctor may prescribe phototherapy (also known as light therapy) and/or systemic medications, including biologic drugs. Phototherapy involves regularly exposing the skin to light, and systemic medications are prescription drugs administered orally or by injection that work throughout the body.
- Lithium: Used to treat manic depression and other psychiatric disorders. Lithium aggravates psoriasis in about half of those with psoriasis who take it.
- Antimalarials: Plaquenil, Quinacrine, chloroquine and hydroxychloroquine may cause a flare of psoriasis, usually 2 to 3 weeks after the drug is taken. Hydroxychloroquine has the lowest incidence of side effects.
- Inderal: This high blood pressure medication worsens psoriasis in about 25 percent to 30 percent of patients with psoriasis who take it. It is not known if all high blood pressure (beta blocker) medications worsen psoriasis, but they may have that potential.
- Quinidine: This heart medication has been reported to worsen some cases of psoriasis.
- Indomethacin: This is a nonsteroidal anti-inflammatory drug used to treat arthritis. It has worsened some cases of psoriasis. Other anti-inflammatories usually can be substituted. Indomethacin's negative effects are usually minimal when it is taken properly. Its side effects are usually outweighed by its benefits in psoriatic arthritis.