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75 to 80% of psoriasis patients present with patches which we call plaques, which are red, scaly, localized patches, elbows, knees, back, different areas. Other patients present with different forms of psoriasis, we call them Guttate, which are little drops of psoriasis, which traditionally are seen in young people who get a strep infection and they get a shower of these little drops of psoriasis we call Guttate. And then there's what we call inverse psoriasis where body folds, like breast folds, groin folds, buttock creases, behind the ears, that can be by itself or can be associated with the other forms of psoriasis.
Then there's psoriasis which doesn't just produce the red, scaly patches but produces what we call pustules, little pus pockets of psoriasis; this usually can affect hands and feet. That's what we call pustulous psoriasis. And then we have a form of psoriasis that is probably the least common, where the whole body gets red and inflamed almost like a severe sunburn and peels constantly. That's what we call erythrodermic psoriasis.
Psoriasis patches have three cardinal features: They are red, a very specific fairly, fairly lively red color; they are thickened, in other words you can feel them, they are thicker on the outside; and then the final thing is the so-called silvery scale, a silver-type scale that sheds itself regularly in psoriasis. The majority of patients with psoriasis don't just have a visible skin disease, they have itching, they have stinging, they have burning, and these are frequent symptoms that need to be alleviated along with the physical side of psoriasis.
A doctor talks about the different types of psoriasis and the symptoms associated with them.
Dr. Menter is chairman of the Division of Dermatology at a prominent U.S. academic medical center. Dr. Menter is also a paid consultant of AbbVie.
Raised, red, inflamed lesions
Silvery scaly plaques
Small, red, individual spots (more common in children and young adults)
Dry skin that may crack and bleed
Itching, burning, or soreness of the skin
Pitted nails or separation from the nail bed
The most common areas for psoriasis to appear include the knees, elbows, and torso. However, psoriasis can appear anywhere on the body, including the face, hands, feet, nails, genitals, and skin folds. Because the skin in each of these body areas is different, they may require different treatments.
If you have pain, stiffness, or swelling in your joints, you could be experiencing symptoms of a related condition called psoriatic arthritis.
Be sure to let your doctor know about any symptoms you are having.
Do you experience the burning and biting itch known as “psoriatic itch”? Some people find the itch more difficult to tolerate than visible redness and scales on their skin.
There are also steps you can take at home to soothe psoriasis symptoms, such as:
Keeping your skin moisturized
Applying a keratolytic (a cream to soften skin scales)
Showering in cold water or using a cold pack. Stay away from hot water, which can dry skin further
You may want to ask your pharmacist for additional recommendations. Always be sure to talk with your doctor before making any changes in medications or routines.
Most people with psoriasis go through cycles where their psoriasis symptoms seem almost to disappear for a period, then flare up again. Although it may not be possible to control them completely, certain behaviors may worsen existing symptoms or cause flare-ups, including smoking, heavy alcohol consumption, and cold weather.
Making lifestyle changes, like eating healthy or not smoking, can be challenging. But they could positively impact your life with psoriasis.