There are five types of psoriasis. The most common form,
plaque psoriasis, appears as raised, red patches covered with a silvery white
buildup of dead skin cells. Psoriasis can occur on any part of the body and is
associated with other serious health conditions, such as diabetes, heart
disease and depression.
Symptoms and diagnosis
Psoriasis is an autoimmune disease that
causes raised, red, scaly patches to appear on the skin. It typically affects
the outside of the elbows, knees or scalp, though it can appear on any
location. Some people report that psoriasis is itchy, burns and stings.
If you develop a rash that doesn't go
away with an over-the-counter medication, you should consider contacting your
doctor.
Diagnosis
About 95 percent of the time, your health
care provider can make a psoriasis diagnosis just by visual inspection. Your
doctor will consider where the raised, red, scales appear, if they have
well-defined edges and how the rash responds to medication when making a
diagnosis.
Psoriasis may seem similar to eczema,
but there are several differences:
- 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.
When biopsied, psoriasis skin looks
thicker and inflamed when compared to skin with eczema.
Your doctor also will want to learn
about your family history. About one-third of people with psoriasis have a
family member with the disease, according to dermatologist Dr. Paul Yamauchi
with the Dermatology and Skin Care Institute in Santa Monica, Calif.
Types of Psoriasis
Psoriasis 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.Plaque Psoriasis (psoriasis vulgaris)
Guttate
Inverse
Pustular
Pustular [PUHS-choo-lar] psoriasis in characterized by white pustules (blisters of noninfectious pus) surrounded by red skin. The pus consists of white blood cells. It is not an infection, nor is it contagious.Erythrodermic
Erythrodermic [eh-REETH-ro-der-mik] psoriasis is a particularly inflammatory form of psoriasis that often affects most of the body surface. It may occur in association with von Zumbusch pustular psoriasis. It is a rare type of psoriasis, occurring once or more during the lifetime of 3 percent of people who have psoriasis. It generally appears on people who have unstable plaque psoriasis. This means the lesions are not clearly defined. Widespread, fiery redness and exfoliation of the skin characterize this form. Severe itching and pain often accompanies it.Psoriasis on Specific Locations
Psoriasis 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
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 »Face
Facial psoriasis most often affects the eyebrows, the skin between the nose and upper lip, the upper forehead and the hairline. You might need a biopsy to confirm that it is psoriasis. Read more about facial psoriasis »Hands, Feet and Nails
It is important to treat acute flares of psoriasis on the hands and feet promptly and carefully. In some cases, cracking, blisters and swelling accompany flares. Nail changes occur in up to 50 percent of people with psoriasis and at least 80 percent of people with psoriatic arthritis. Learn more about how to treat psoriasis on hands, feet & nails »Genital Psoriasis
The most common type of psoriasis in the genital region is inverse psoriasis. There are various regions of the genital area that can be affected by psoriasis. More information about genital psoriasis »Skin Folds
Inverse psoriasis can occur in skin folds such as the armpits and under the breasts. This form of psoriasis is frequently irritated by rubbing and sweating. Read more about treating psoriasis in skin folds »Psoriasis Severity
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.
Psoriasis Causes and Known Triggers
Scientists believe that at least 10
percent of the general population inherits one or more of the genes that create
a predisposition to psoriasis. However, only 2 percent to 3 percent of the
population develops the disease. Researchers believe that for a person to
develop psoriasis, the individual must have a combination of the genes that
cause psoriasis and be exposed to specific external factors known as
"triggers". Read more
about the science of psoriasis »
Psoriasis triggers are not universal.
What may cause one person's psoriasis to become active, may not affect another.
Established psoriasis triggers include:
Stress
Stress can cause psoriasis to flare for
the first time or aggravate existing psoriasis. Relaxation and stress
reduction may help prevent stress from impacting psoriasis.
Injury
to skin
Psoriasis can appear in areas of the
skin that have been injured or traumatized. This is called the Koebner
[KEB-ner] phenomenon. Vaccinations, sunburns and scratches can all trigger a
Koebner response. The Koebner response can be treated if it is caught early
enough.
Medications
Certain medications are associated with
triggering psoriasis, including:
- 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.
Infection
Anything that can affect the immune
system can affect psoriasis. In particular, streptococcus infection (strep
throat) is associated with guttate psoriasis. Strep throat often is associated
with the first onset of guttate psoriasis in
children. You may experience a flare-up following an earache, bronchitis,
tonsillitis or a respiratory infection, too.
It's not unusual for someone to have an
active psoriasis flare with no strep throat symptoms. Talk with your doctor
about getting a strep throat test if your psoriasis flares.
Learn
more about how psoriasis can affect your risk for infection »
Although scientifically unproven, some
people with psoriasis suspect that allergies, diet and weather trigger their
psoriasis. Strep infection is known to trigger guttate psoriasis.
If you need
Information about Insurance,
