Psoriasis is an autoimmune condition that causes cells to develop rapidly on the skin. This overgrowth can lead to thick, scaly plaques that may itch or cause discomfort. There are several different types of psoriasis that vary, depending on the appearance of the scales and their location on the body. In the United States, over 8 million people have psoriasis. Environmental triggers often cause symptoms of psoriasis to flare. While a person cannot cure these symptoms, recent developments in psoriasis treatment mean that they can reduce the number of flares, and their severity. In this article, we explain the different psoriasis types, their symptoms, and how to treat them.

Symptoms Share on Pinterest Psoriasis may cause intense itching and discomfort. The main symptoms of psoriasis are red, flaky, crusty patches, that may have easily-shed, silvery scales covering them. They are also likely to cause an intense itching or burning sensation. Symptoms of psoriasis develop in flares that occur for different lengths of time with periods of remission in between when they clear up. Remission periods last for an average of 1–12 months at a time. The duration of both flares and periods of remission can be challenging to predict, however. Symptoms range from mild to severe and may present differently, according to the type of psoriasis. According to the National Psoriasis Foundation: mild psoriasis covers less than 3% of the body

moderate psoriasis covers 3–10% of the body

severe psoriasis covers in excess of 10% of the body Plaques might develop anywhere but commonly occur as small patches on the elbows, knees, lower back, and scalp.

Types There are several forms of psoriasis, as described below. Plaque psoriasis About 80–90% of people with psoriasis have plaque psoriasis. It usually shows as raised, inflamed, red lesions, covered by silvery, white scales, most often on the elbows, knees, scalp, and lower back. Inverse psoriasis Inverse psoriasis develops in the following areas: the armpits

the groin

under the breasts

other skin folds, such as around the genitals and buttocks Inverse psoriasis has red lesions, usually without the scales that occur in plaque psoriasis. The lesions might be smooth and shiny. Irritation from rubbing and sweating can make this type of psoriasis worse due to its location in skin folds and tender areas. It is more common in people who are overweight and those with deep skin folds. Erythrodermic psoriasis Erythrodermic psoriasis is a particularly inflammatory but rare type that can cause large areas of fiery redness across the surface of the body. People with unstable plaque psoriasis, where lesions do not have clearly defined edges, may develop erythrodermic psoriasis. There may also be exfoliation, or peeling of the skin, severe itching, and pain. Erythrodermic psoriasis disrupts the body’s chemical balance. This interference may cause protein and fluid loss that can lead to severe illness. Edema, or swelling from fluid retention, may also occur. This complication is likely to develop around the ankles. The body may have difficulty regulating its temperature, which can cause shivering. Erythrodermic psoriasis can also lead to pneumonia and congestive heart failure. The complications of erythrodermic psoriasis can be dangerous. Anyone who shows symptoms of this condition should see a doctor right away. People with erythrodermic psoriasis may spend time in the hospital if symptoms are severe. Guttate psoriasis Guttate psoriasis often starts in childhood or young adulthood. It appears as small, red, individual spots on the skin. The spots are not usually as thick or as crusty as the lesions in plaque psoriasis. A range of conditions can trigger guttate psoriasis, including: upper respiratory infections

streptococcal infections

tonsillitis

stress

injury to the skin

certain medications, including antimalarials, lithium, and beta-blockers. Guttate psoriasis may resolve without treatment and never return. However, it may clear and reappear later as patches of plaque psoriasis.p Pustular psoriasis Pustular psoriasis affects adults more than children, and it accounts for fewer than 5% of psoriasis cases. It appears as white pustules, or blisters of noninfectious pus, which red skin surrounds. It can affect certain areas of the body, for example, the hands and feet, or most of the body. It is not an infection, and it is not contagious. Pustular psoriasis tends to have a cycle, in which the formation of pustules and scaling follows reddening of the skin. While psoriasis can form anywhere on the human body, below are some of the most common areas.

Causes Share on Pinterest Stress can trigger flares of psoriasis symptoms. While the cause of psoriasis is still unclear, scientists believe that it is an autoimmune disease. Autoimmune diseases affect the immune system, which produces T cells to protect the body against infectious agents. In people with psoriasis, triggers can lead to their genes instructing the immune system to target the wrong cells. T cells respond to a trigger as if they are fighting an infection or healing a wound. They produce chemicals that cause inflammation. In psoriasis, this autoimmune activity leads to the excessive growth of skin cells. Typically, skin cells take about 21–28 days to replace themselves. However, in people with psoriasis, they take around 2–6 days. Triggers will be different in each individual with psoriasis, but common triggers include: stress and anxiety

injuries to the skin

infections

hormonal changes Medications that can trigger a psoriasis flare include: lithium

antimalarials

quinidine

indomethacin Some people associate psoriasis with allergies, diet, and weather, but no evidence has yet supported these theories. Importantly, psoriasis is not contagious. Knowing this can help people with the disease cope with the more challenging parts of socializing.

Risk factors Some factors increase the risk of a person developing psoriasis. These factors include: having cardiovascular disease and metabolic syndrome

trauma to the skin

family history of the condition About 1 in 3 people with a close relative who has psoriasis will also develop the condition. If one parent has psoriasis, there is a 10% chance that their child will go on to develop the disease. This risk increases to 50% if both parents have psoriasis. This correlation in families suggests an underlying genetic component. However, symptoms of the disease may not show unless an environmental factor triggers it to become active. At least 10% of the population may have the gene that causes psoriasis, but only 2–3% of people develop it. Among younger people, psoriasis may flare after an infection, notably strep throat. Symptoms will become noticeable 2–6 weeks after an earache or respiratory infection in 33–50% of young people with psoriasis. Common respiratory infections include strep throat, bronchitis, and tonsillitis. Psoriasis is equally common in males and females. It can begin at any age, but it is most common between 15–35 years. The average time of onset is 28 years of age. Around 10–15% of people with psoriasis develop the condition before they are 10 years of age. Find out more about the triggers and risk factors for psoriatic flare-ups.

Diagnosis There are no blood tests that can confirm psoriasis. A person who has a persistent rash that does not resolve with over-the-counter (OTC) remedies may want to talk to a doctor about psoriasis. Often, recognizing and treating symptoms early on improves the long-term outcomes of psoriasis. A doctor will examine the symptoms and ask about personal and family history. They might also carry out a skin biopsy to rule out other conditions, such as eczema.