Types of Psoriasis
Psoriasis is a chronic, immune-mediated skin condition that manifests in various forms, each with distinct characteristics.
Psoriasis is a chronic, immune-mediated skin condition that manifests in various forms, each with distinct characteristics. Understanding the different types of psoriasis can help patients and healthcare providers tailor treatment plans effectively.
Plaque Psoriasis (Psoriasis Vulgaris)
Plaque psoriasis is the most common form, affecting about 80-90% of people with psoriasis. It is characterized by raised, red patches covered with a silvery-white build-up of dead skin cells, typically appearing on the scalp, elbows, knees, and lower back.
- Symptoms: Red, inflamed patches, dry skin, itching, and burning sensations.
- Common Areas: Scalp, elbows, knees, lower back.
Guttate Psoriasis
Guttate psoriasis is the second most common type, often beginning in childhood or young adulthood. It is characterized by small, dot-like lesions, which can cover large portions of the body. This form is often triggered by bacterial infections, such as streptococcus (strep throat).
- Symptoms: Small, red spots on the skin, commonly following a throat infection.
- Common Areas: Trunk, arms, legs.
Inverse Psoriasis
Inverse psoriasis occurs in skin folds, such as under the breasts, around the groin, or in the armpits. The lesions are smooth and shiny rather than scaly and often develop where skin rubs against skin.
- Symptoms: Red, inflamed lesions that appear smooth and shiny.
- Common Areas: Armpits, under breasts, groin, and around genitals.
Pustular Psoriasis
Pustular psoriasis is a rare but severe form of psoriasis characterized by white pustules (blisters of non-infectious pus) surrounded by red skin. It can be localized to specific areas, such as the hands and feet, or widespread over the body.
- Symptoms: Pus-filled blisters, redness, tenderness, fever, chills, and itching.
- Common Areas: Hands, feet, generalized across the body.
Erythrodermic Psoriasis
Erythrodermic psoriasis is a particularly inflammatory form of psoriasis that affects most of the body surface. It is a life-threatening condition requiring immediate medical attention. The skin appears intensely red and is often accompanied by severe itching and pain.
- Symptoms: Intense redness covering large areas, shedding of skin in large sheets, severe itching, and pain.
- Common Areas: Generalized over the entire body.
Nail Psoriasis
Nail psoriasis affects the fingernails and toenails, causing various changes that can be mistaken for fungal infections. This form of psoriasis can lead to pitting, abnormal nail growth, and discoloration.
- Symptoms: Pitting, thickening, and discoloration of the nails, detachment of the nail from the nail bed.
- Common Areas: Fingernails and toenails.
Scalp Psoriasis
Scalp psoriasis is common among those with psoriasis, with about 50% of patients experiencing it. It can range from mild, fine scaling to severe, thick, crusted plaques covering the entire scalp, extending to the forehead, back of the neck, and around the ears.
- Symptoms: Red patches, dandruff-like flaking, silvery-white scales, itching, soreness.
- Common Areas: Scalp, forehead, back of neck, around ears.
Sources:
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Telfer, N. R., et al. (1992). The role of streptococcal infection in the initiation of guttate psoriasis. Archives of Dermatology, 128(1), 39-42.
Patel, M., & Jacobson, K. (2017). Psoriasis: Inverse psoriasis. Dermatologic Therapy, 30(4), e12525.
Zelickson, B. D., & Muller, S. A. (1991). Generalized pustular psoriasis: A review of 63 cases. Archives of Dermatology, 127(9), 1339-1345.
Boyd, A. S., & Menter, A. (1989). Erythrodermic psoriasis: Precipitating factors, course, and prognosis in 50 patients. Journal of the American Academy of Dermatology, 21(5), 985-991.
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Van de Kerkhof, P. C. M. (1998). Management of scalp psoriasis: Guidelines for corticosteroid use in combination treatment. American Journal of Clinical Dermatology, 19(2), 165-171.