Psoriasis signs and symptoms can vary from person to person but may include one or more of the following:
- Red patches of skin covered with silvery scales
- Small scaling spots (commonly seen in children)
- Dry, cracked skin that may bleed
- Itching, burning or soreness
- Thickened, pitted or ridged nails
- Swollen and stiff joints
Depending on the type and location of the psoriasis and how widespread the disease is, psoriasis can cause serious health conditions such as diabetes, heart disease, cardiovascular disease, high blood pressure, thickened skin and bacterial skin infections, and depression.
Psoriasis patches can range from a few spots of dandruff-like scaling to major eruptions that cover large areas. Mild cases of psoriasis may be a nuisance; more-severe cases can be painful, disfiguring and disabling.
Anyone can develop psoriasis, but psoriasis typically starts or worsens because of a trigger such as:
- Immune system deficiencies such as HIV, strep throat or thrush
- Injuries to the skin, such as a cut or scrape, bug bite or a severe sunburn
- Cold weather
- Smoking tobacco
- Heavy alcohol consumption
- Medications including lithium, beta blockers, antimalarial drugs and iodides
The most common form, plaque psoriasis causes dry, raised, red skin lesions (plaques) covered with silvery scales. These patches or plaques most often appear on the scalp, knees, elbows and lower back. They are often itchy and painful, and they can crack and bleed and can occur anywhere on your body, including genitals and the soft tissue inside your mouth. You may have just a few plaques or many, and in severe cases, the skin around your joints may crack and bleed.
Plaque Psoriasis Treatments: Topical treatments, phototherapy, and systemic medications that work throughout the entire body. No single treatment works for 100% of the time on everyone; so your treatment may be a combination of treatments.
Guttate psoriasis is the second most common form of psoriasis and is usually triggered by a bacterial infection such as strep throat. This primarily affects people younger than 30 and often starts in childhood. It’s marked by small, water-drop-shaped red spots on your trunk, arms, legs and sometimes on the scalp, face and ears. The sores are covered by a fine scale and aren’t as thick as typical plaques. You may have a single outbreak that goes away on its own, or you may have repeated episodes, especially if you have ongoing respiratory infections, strep throat, tonsillitis, stress or a skin injury.
Guttate Psoriasis Treatments: Topical treatments such as steroids are the most frequent treatment as they reduce the swelling and redness of the lesions. Phototherapy treatment with ultraviolet light is also is very effective for guttate psoriasis. Only in severe cases will doctors prescribe systemic medications (drugs given orally or by injection) for this type of psoriasis. Sometimes, a short course of one of these drugs results in rapid and prolonged clearing of guttate psoriasis.
Additional Types of Psoriasis:
Nail Psoriasis. Psoriasis can affect fingernails and toenails, causing pitting, abnormal nail growth, discoloration and in sever cases may cause the nail to crumble.
Scalp Psoriasis. Psoriasis on the scalp is itchy and appears red with silvery-white scales. If you scratch your scalp you may notice dead skin in your hair or on your shoulders.
Inverse psoriasis. Inverse psoriasis causes smooth patches of red, inflamed skin which typically affects the skin in areas where friction and sweating occur such as the armpits, the groin, under the breasts and around the genitals.
Pustular Psoriasis. This uncommon form of psoriasis can occur in widespread patches (generalized pustular psoriasis) or in smaller areas on your hands, feet or fingertips. It generally develops quickly, with pus-filled blisters appearing just hours after your skin becomes red and tender. The blisters may dry out in a day or two, but may reappear every few days or weeks. Generalized pustular psoriasis can also cause fever, chills, severe itching and tiredness.
Erythrodermic Psoriasis. The least common type of psoriasis, erythrodermic psoriasis can cover your entire body with a red, peeling rash that can itch or burn intensely. It may be triggered by severe sunburn, by corticosteroids and other medications, or by another type of psoriasis that hasn’t been controlled properly.
Psoriatic Arthritis. This disease can develop after a joint injury and may feel like a cartilage tear. Muscle or joint pain can occur without joint swelling. This type of arthritis usually affects the joints closest to the nail in fingers and toes, as well as the lower back, knees and ankles. In addition to inflamed, scaly skin, psoriatic arthritis causes pitted, discolored nails and the swollen, painful joints that are typical of arthritis. It can also lead to inflammatory eye conditions, such as conjunctivitis. It is important to tell your dermatologist if you have aches and pains, as these could be signs of skin disease.
Psoriasis Treatment Approach
The traditional approach is to start with the mildest treatments, such as topical creams and ultraviolet light therapy (phototherapy) and then progress to stronger ones based on your results. Sometimes combinations are required because what works well for one person may not work the same way on another person. So if your therapy isn’t working for you, be sure to tell your doctor, so that he/she can make the necessary adjustments on your particular plan. Our goal is to find the most effective way to treat your specific type of psoriasis with the fewest possible side effects.