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What is Psoriasis? What causes it? How is it treated?
Psoriasis is an autoimmune disorder that causes the body to produce too much keratin, the protein that forms the outer layer of skin. When this happens, skin cells grow too rapidly and form thick patches of rough, bright red skin that are itchy, flaky, and sometimes painful. The appearance of these patches depends upon the severity of psoriasis. It may be mild and not noticeable, or it may cover large areas of the body. Treatments for psoriasis vary according to the type, location and severity of the disease.
There are multiple types of psoriasis, which are diagnosed based on visual examination and, if needed, with blood tests. Psoriasis can flare up throughout your life or come and go. It may clear up for months or years at a time only to return again with full force.
Psoriasis is not contagious, but it often is generic and will run in families, so it is likely that family members will have similar cases of psoriasis. Psoriasis can affect all areas of the body, but it most commonly appears on the arms and legs.
What are the different types of psoriasis?
There are many different forms of psoriasis. Let’s go through each one
The first is plaque psoriasis. Plaque psoriasis is the most common form of this skin disease. It typically appears on the scalp, elbows and knees, although it can appear anywhere. When plaque psoriasis appears, you may see: patches of thick, raised skin called plaques; scale (a dry, thin, and silvery-white coating) covers some plaques; small lesions joining together to form larger plaques. It’s important to obtain treatment from a certified dermatologist to minimize symptoms.
The second type of psoriasis is guttate psoriasis. Guttate psoriasis (pronounced: gut-tate) is a common form of psoriasis. It involves small, salmon-colored bumps on the skin that tend to clear in a few weeks or months without treatment. These tiny scaly patches of skin can appear anywhere on the body, but it’s most common on the torso, legs and arms. People with guttate psoriasis are at risk to develop plaque psoriasis later in life. Guttate psoriasis may simply disappear after each flare-up or it can become a lifelong condition.
The third type of psoriasis is pustular psoriasis. Pustular psoriasis is a rare subtype in which you develop pus-filled bumps on your hands, feet and scalp. While the pus-filled bumps may look like an infection, the skin is not infected. The bumps don’t contain bacteria or anything else that could cause an infection. Where pustular psoriasis appears, you tend to notice: Red, swollen skin that is dotted with pus-filled bumps, Extremely sore or painful skin, Brown dots (and sometimes scale) appear as the pus-filled bumps dry.
Generalized Pustular Psoriasis (GPP) is a rare, life-threatening form of psoriasis. With this type of psoriasis, widespread redness and swelling will progress to pus-filled bumps on multiple areas of the skin. The symptoms of pustular psoriasis may include: fever; red face and neck; pain; swelling; tenderness; peeling; sensitivity to touch; nausea and vomiting; headaches; fatigue; pallor (dry, pale skin); abdominal bloating. Individuals may go on to develop other infections while they have pustular psoriasis. It is important to seek medical care for treatment.
The fourth type of psoriasis is inverse psoriasis. Inverse psoriasis is an uncommon form of psoriasis that may appear in the armpits, genital area, and the creases on your side or back. You may see red patches of skin that look raw and painful. These areas typically don’t have a silvery-white coating, but can be scaly instead. Other names for this type of psoriasis are intertriginous psoriasis or flexural psoriasis.
The fifth type of psoriasis is erythrodermic psoriasis. Erythrodermic psoriasis is rare and serious. Once a person develops erythrodermic psoriasis, symptoms are typically severe and appear quickly. The skin becomes red and scaly, and covered in blisters that ooze fluid. As much as 80 percent of the body can be affected. Symptoms include: chills, fever, muscle weakness, and an elevated heart rate. Some people with erythrodermic psoriasis may become severely ill or even die if they aren't treated within 24 hours of the onset of symptoms. Immediate medical attention is necessary so that the doctor can prescribe medications to slow down the progression of this disease and relieve its symptoms.
The sixth type of psoriasis is nail psoriasis. Nail psoriasis is a form of psoriasis on your fingernails or toenails. For people who have nail psoriasis, their fingernails and toenails may change from looking normal to having pits and ridges, thickening or thinning, discoloration, and pain. The nail can become detached from the nail bed, which is the tissue beneath it. Treatment for nail psoriasis (often using the same medications for plaque psoriasis) and proper nail care can help you control your signs of disease.
The seventh type of psoriasis is psoriatic arthritis. Psoriatic arthritis is a condition in which the body attacks the joints and causes inflammation, pain and swelling. Psoriatic arthritis most commonly affects the joints of the hands and feet, but it can also affect the joints of the spine (backbone) as well as those in other parts of the body. The resulting damage from this autoimmune disease causes stiffness, deformity of joint structures, chronic pain and loss of function.
If you have psoriasis, it’s important to pay attention to the condition of your joints. It’s possible to get psoriatic arthritis before getting psoriasis, but this is less common. When you start getting joint pain, be sure you mention it to your doctor immediately. Similar to psoriasis, the cause of psoriatic arthritis is unclear, but it's more common in people who have family members affected by psoriasis. Your symptoms will depend on which joints are affected by the disease and how severe it is. Some people with psoriasis also have psoriatic arthritis, but not everyone does.
The eight type of psoriasis is Scalp Psoriasis. It can appear as thing, red flaky patches that can itch and cause irritation. These patches can spread from the scalp to the forehead, behind the ears, and down to the neckline. For people with scalp psoriasis, they may even experience hair loss due to the irritation and inflammation.
For the best care of your skin and health, it is important to seek out the attention of a board certified dermatologist. You can find your nearest board certified dermatologist by visiting AAD.org
If you think you or a loved one might have psoriasis, seek care from a certified dermatologist. Different types of psoriasis may respond differently to various treatments and the best course of action for you may not be the same for someone else.
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-Dr. Del Campo