Psoriasis is an autoimmune condition that causes thick, scaly plaques to form on the skin.
While there is no cure, treatment can help reduce the frequency and severity of psoriasis flares.
The condition leads to the buildup of skin cells, forming bumpy patches that can appear anywhere on the body, though they are most commonly found on the scalp, elbows, knees, and lower back.
Inflammation and redness around the scales are common. Typical psoriatic scales are whitish-silver and develop in thick, red patches.
However, in individuals with darker skin tones, these patches may appear more purplish or dark brown with gray scales. In some cases, the patches may crack and bleed.
Psoriasis results from a sped-up skin cell production process. Normally, skin cells grow deep within the skin, gradually rise to the surface, and eventually shed. The typical life cycle of a skin cell is about one month.
Psoriasis is not contagious, meaning it cannot be passed from person to person. However, it can sometimes occur in multiple members of the same family.
Types of Psoriasis
Plaque Psoriasis
Plaque psoriasis is the most common type of psoriasis. Lesions typically occur on the trunk, buttocks, scalp, and extremities, but they may appear anywhere on the body.
It presents as raised and inflamed lesions, which may vary in appearance depending on a person’s skin tone:
Pustular Psoriasis
Pustular psoriasis is more common in adults. It causes white, pus-filled blisters and broad areas of red or violet—depending on skin tone—inflamed skin. On darker skin tones, it can appear more intensely violet.
Guttate Psoriasis
Guttate psoriasis commonly occurs in childhood. This type of psoriasis causes small, individual spots on the skin.
They are typically not as thick or crusty as the lesions seen in plaque psoriasis. A variety of conditions can trigger guttate psoriasis, including:
Skin injury
Tonsillitis
Stress
Upper respiratory infection
Inverse Psoriasis
Inverse psoriasis develops in skin folds and commonly affects:
The groin
The armpits
The genitals and buttocks
The areas under the breasts
Inverse psoriasis typically produces lesions without the scales found in plaque psoriasis.
The lesions might be smooth and shiny. It is more common among people who are overweight or have deep skin folds.
Erythrodermic Psoriasis
Erythrodermic psoriasis is a severe and rare type of psoriasis, according to the National Psoriasis Foundation.
This form often covers large sections of your body at once. The skin may appear sunburned, and scales that develop often slough off in large sections or sheets. It’s not uncommon to experience a fever or become very ill with this form of psoriasis.
Causes of Psoriasis
Infections
Stress and anxiety
Cold, dry weather
Skin injuries such as sunburn or scratches
Smoking
Obesity
Hormonal changes
Medications like NSAIDs, lithium, beta-blockers, and antimalarials
Risk Factors
Smoking
Genetics
Stress
Low immune function
Obesity
Alcohol use
Infection
Hypertension
Diabetes
Trauma to the skin
Metabolic syndrome
Cardiac disease
Symptoms of Psoriasis
The most common symptoms of plaque psoriasis include:
Dry skin that may crack and bleed
Soreness around patches
Thick, pitted nails
Painful, swollen joints
Whitish-silver scales or plaques on red patches
Itching and burning sensations around patches
Raised, inflamed patches of skin that appear red on light skin and brown or purple on dark skin
Poor sleep
Joint pain
Diagnosis
Physical exam: Psoriasis is usually easy for doctors to diagnose, especially if you have plaques on areas such as your:
Knees
Elbows
Ears
Nails
Scalp
Belly button
Lab tests or skin biopsy
Treatment and Management
Common psoriasis treatments include:
Moisturizers for dry skin
Steroid creams
Vitamin D3 ointment
Vitamin A or retinoid creams
Medications to slow skin cell production
Medicated lotions or shampoos
Salicylic acid
Coal tar
Anthralin
Retinoid creams
Calcineurin inhibitors
Creams or ointments may be enough to improve the rash in small areas of skin. However, if your rash affects large areas or you also have joint pain, you may need additional treatments.
What if common psoriasis treatments don’t work?
Light therapy
PUVA
Retinoids
Immune therapies
Cyclosporine
Methotrexate
Before starting treatment, talk to your healthcare provider about the side effects and mention any medications or supplements you are currently taking to avoid drug interactions.
Prevention
Avoid triggers
Regularly moisturize the skin
Recognize and avoid food triggers
Maintain a healthy weight
Reduce stress
Exercise regularly (yoga and meditation)
Avoid smoking and alcohol
Follow a healthy diet
Use topical home remedies to reduce itching
Maintain good hygiene
Complications of Psoriasis
Anxiety
Depression
Cardiovascular disease
Metabolic syndrome
Dyslipidemia
Obesity
Hair loss
Diabetes
Psoriatic arthritis
Eye disease
Kidney disease
Psychiatric disorders
Some types of cancer, including lung cancer, lymphoma, and non-melanoma skin cancer
