Different Types of Psoriasis

The symptoms of psoriasis can develop differently for everyone, and vary based on type. In general, psoriasis is a chronic condition that presents as a rash with scaly patches that may cause itching. Psoriasis is also an immune-mediated disease, which means that it occurs due to an abnormal response from the immune system, causing skin cells to build up more quickly than they should. The condition can impact other body parts as well, including the joints and the cardiovascular system.

There are several subsets of psoriasis, each with its own unique characteristics. Here’s a guide to the different types.

Plaque Psoriasis

Plaque psoriasis is the most common form of psoriasis, affecting 80 to 90% of psoriasis patients. In this type, plaques appear as raised, red or dark brown patches with silvery buildup of skin cells. Typically, the plaques develop symmetrically on the body, and are most likely to occur on the knees, elbows, scalp, and lower back.

Avoiding known triggers, such as stress or lack of sleep, could help to control the symptoms of plaque psoriasis. Other treatments may involve moisturizers, topical retinoids, immunosuppressive drugs, biologics, or light therapy.

Nail Psoriasis

Many people with psoriatic arthritis, a joint condition linked with psoriasis, develop nail psoriasis. This condition presents as small pits in the nails, detachment of the nail from the nail bed, the development of a chalky substance beneath the nail, and discoloration. People with nail psoriasis are also more likely to develop fungal infections of the nails. While the condition can be difficult to treat, topical/intralesional steroids and systemic medications may be used in some cases.

Guttate Psoriasis

In guttate psoriasis, small, pinkish-red patches develop on the body. They’re most likely to appear on the upper arms, thighs, trunk, and scalp. The condition is common in children and young adults, and is typically triggered by a streptococcal infection. Guttate psoriasis may vanish on its own within several weeks, but more stubborn cases may call for treatment such as topical medications or phototherapy.

Inverse Psoriasis

A hidden but uncomfortable condition, inverse psoriasis develops in skin folds such as areas under the breast, in the groin, and the armpits. The friction and sweating that occurs in these areas can lead to worsening symptoms. For people of color, inverse psoriasis presents as dark brown or purplish lesions, while Caucasian people may experience bright red patches. Up to 30% of people with psoriasis develop this form, which may be controlled with topical treatments or systemic medications.

Pustular Psoriasis

Pustular psoriasis occurs when widespread areas of skin become inflamed and develop pustules. These pus-filled bumps contain white blood cells, which do not indicate an infection and are not contagious. Oftentimes, the pustules develop in cycles, with new ones forming every few days or weeks. The condition can be painful and calls for medical attention, which may include creams, systemic pills or injections, or biologic medications.

Erythrodermic Psoriasis

A rare but serious condition, erythrodermic psoriasis resembles a severe burn, with a red rash forming across most of the body. The rash can also cause fever, chills, dehydration, and an increased risk for complications like heart failure and infection. 

It’s estimated that just 3% of people with other forms of psoriasis develop this condition, possibly from abruptly stopping other psoriasis treatments or overusing medications. Certain illnesses and infections, severe sunburns, and allergic reactions may also lead to erythrodermic psoriasis. Treatments may include cool compresses, topical ointments, immunosuppressants, and other medications.

If you have psoriasis of any type, turn to Olansky Dermatology for solutions to help manage your symptoms. Our team can treat mild and severe psoriasis with treatment options tailored to your needs. Schedule a comprehensive consultation online or by calling (404) 355-5484.