Psoriasis: Types, Symptoms, Treatment
Discover comprehensive insights on psoriasis, a chronic autoimmune condition affecting millions worldwide. Learn about its types, symptoms, causes, treatments, and lifestyle tips to manage this complex skin disorder effectively.
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Last updated on 5th May, 2025
Psoriasis is a chronic autoimmune disease that primarily affects the skin, resulting in an accelerated life cycle of skin cells. This causes cells to accumulate on the skin’s surface, resulting in scales and inflamed areas. While it is not contagious, it greatly affects the lives of those affected.
Keep reading to learn its types, symptoms, causes, risk factors, and more.
Understanding the Various Types of Psoriasis
There are several types of psoriasis, some of them include:
Plaque Psoriasis
The most common form is plaque psoriasis, which makes up 80% to 90% of cases. It features thick, red patches coated with silvery-white scales. These lesions usually develop on the scalp, elbows, knees, and lower back.
Untreated plaque psoriasis can lead to significant discomfort and skin cracking, with severity that can vary between individuals. People with plaque psoriasis can have cycles of flares and remissions, making it difficult to maintain effective treatment over the long term.
Guttate Psoriasis
It usually starts in childhood or young adulthood. It shows up as little, red, drop-like spots on the skin. In contrast, guttate lesions are thinner and appear mainly on the trunk, upper arms, and thighs, unlike the more common plaque psoriasis.
It is often caused by bacterial infections like strep throat. Guttate psoriasis can disappear on its own in some cases, while others may need to be treated with medication to avoid progression towards chronic plaque psoriasis.
Inverse Psoriasis
This type of psoriasis presents as smooth, shiny, inflamed patches in skin folds, like under the breasts, around the groin, or near the buttocks.
Friction and sweating often worsen this type, making it difficult to manage without proper care. The affected areas are sensitive, and the condition is often confused with a fungal or bacterial infection, thereby requiring an accurate diagnosis.
Pustular Psoriasis
Less common than other types, it features white pustules (blisters of non-infectious pus) surrounded by red skin. It can be localised to certain areas, such as the hands and feet, or widespread.
This type can appear suddenly and may be preceded, in severe cases, by fever, chills, and fatigue. Early management is vital to prevent complications and to optimise patient comfort.
Erythrodermic Psoriasis
It is the rarest but most severe type of psoriasis, resulting in widespread redness, scaling, and shedding of the skin, and is often accompanied by severe itching and pain. This type can be caused by poorly controlled psoriasis or sudden withdrawal from systemic treatment and requires urgent medical attention.
The more severe form of erythrodermic psoriasis can cover the entire body at once, causing dehydration and infection. Such cases may also require hospitalisation.
Symptoms of Psoriasis
Some symptoms of psoriasis are red or pink patches of skin, scaling, itching, and discomfort. These symptoms differ in severity based on the kind and degree of illness.
For some, this could just be a mild discomfort, but others could have a prolonged outbreak that could last for long periods, causing significant disruption to daily life. Early identification of these symptoms can help with early treatment and management.
Specific symptoms for different types of psoriasis are mentioned in the table below:
| Psoriasis Type | Symptoms |
| Plaque Psoriasis | Thickened, scaly patches with defined edges |
| Guttate Psoriasis | Drop-shaped spots that spread across the body |
| Inverse Psoriasis | Smooth lesions prone to irritation |
| Pustular Psoriasis | Blisters containing pus, sometimes with systemic symptoms |
| Erythrodermic Psoriasis | Severe redness, peeling, and widespread inflammation |
Causes and Risk Factors of Psoriasis
Psoriasis is highly genetic. It is estimated that 30% of patients with psoriasis have a family history of the disease. Certain genes, for example, those related to immunity, can increase susceptibility. Stratifying these genetic markers can help provide early diagnosis and personalised treatment strategies.
There are certain triggers that influence psoriasis flare-ups. These are:
| Trigger Factors | Examples |
| Infections | Streptococcal infections |
| Stress | Emotional stress |
| Medications | Beta-blockers, lithium |
| Lifestyle Habits | Smoking, excessive alcohol consumption |
| Weather Conditions | Cold, dry weather |
Other skin injuries, such as cuts, burns, or sunburn, can also cause flare-ups, known as the Koebner response.
Diagnosis of Psoriasis
Psoriasis is typically diagnosed by a physician based on a physical examination of the skin, nails, and scalp. The type of psoriasis can be determined by looking at the distinct scales and patches.
Nail Involvement
Pitting or discolouration in the nails can help confirm the diagnosis.
Detailed Medical History
A detailed medical history is usually obtained with information regarding family history and previous skin conditions to accompany the physical examination.
Skin Biopsy
In cases of diagnostic uncertainty, a skin biopsy is done. A small scrape of skin is looked at through a microscope to eliminate other skin diseases, such as dermatitis or fungal infections. The procedure is minimally invasive and helps to ensure an accurate diagnosis.
Psoriasis Treatment Options
Topical treatments are often a first-line treatment for mild to moderate psoriasis. Regular application is crucial to get results. These treatments are often used in combination with moisturisers to improve efficacy.
| Treatment | Purpose |
| Corticosteroids | Reduce inflammation and slow skin cell turnover |
| Vitamin D Medicines | Help normalise skin cell growth |
| Coal Tar | Soothes itching and scaling |
| Salicylic Acid | Aids in removing scales and smoothens skin |
Phototherapy
Phototherapy, or light treatment, uses controlled ultraviolet (UV) light to slow the rapid production of skin cells that occurs with psoriasis. Types of phototherapy include:
Narrow-band UVB light therapy is effective for moderate to severe cases.
PUVA therapy, which combines UVA light and a drug (psoralen) that makes the skin more sensitive to UV light, improves the effects of the treatment.
Sessions are administered under medical supervision to reduce risks like burns or skin damage.
Systemic Medications
Healthcare providers may use systemic medications or injections for moderate to severe or unresponsive cases of psoriasis. Methotrexate, for example, suppresses the immune system to reduce inflammation, while biologics specifically target immune pathways to block the disease process.
An alternative is cyclosporine, which significantly influences immune response but must be closely controlled for side effects, including kidney damage and hypertension.
Lifestyle and Home Remedies for Psoriasis
Here are some lifestyle changes and home remedies for dealing with psoriasis:
A healthy diet may help one manage psoriasis when used in conjunction with conventional medical treatment.
Anti-inflammatory foods like fatty fish, leafy greens, and nuts can help get rid of flare-ups, while processed foods, sugar, and alcohol should be avoided.
Adequate hydration and whole grain consumption are beneficial to skin health and augmentation of skin treatment.
Stress is a major cause of psoriasis flare-ups. Yoga, meditation, and deep-breathing exercises are some forms of effective stress management techniques.
Complications of Psoriasis
Some of the major complications of psoriasis are listed below:
Psoriatic Arthritis
This is a severe complication and can affect up to 30% of psoriasis patients. It causes joint pain, stiffness, and swelling and can cause irreversible joint damage if untreated. Early treatment with joint-specific medications, aka DMARDs (disease-modifying antirheumatic drugs), can prevent joint destruction and improve function.
Emotional Distress
Psoriasis is visible and often leads to emotional distress, low self-esteem, and social withdrawal. Patients may suffer from anxiety or depression, requiring support from mental health. Professional counselling or support groups can help as well.
Conclusion
Psoriasis is a complex disease that has different types, signs, and triggers. Early diagnosis and personalised treatments with lifestyle changes can go a long way in mitigating its effects. Developing a daily routine that incorporates moisturising, using prescribed treatments, and wearing comfortable clothing can help better deal with the condition.
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