There are several forms of psoriasis, each with its own characteristic symptoms, although the same underlying disease causes them all. You may have different types of psoriasis at the same time, or have different types of psoriasis at different points in your life.
Generally speaking, the size and appearance of plaques - raised, reddened patches of skin, usually covered with silvery skin or scales - help to identify the type of psoriasis. The types are:
A serious, but rare, complication of psoriasis is erythroderma, where large areas of the skin become hot, red, and dry.
Chronic plaque psoriasis
The most common form of psoriasis, chronic plaque psoriasis accounts for almost 90 percent of psoriasis in adults. Plaques range from coin-sized to much larger. They especially affect the back of the elbows and the front of the knees and the back
Flexural psoriasis
This type causes red, shiny areas in skin folds eg under breasts, between buttocks etc.
Guttate psoriasis
Identified by small less than one-half inch,'droplet'-like skin changes concentrated on the trunk, this type of psoriasis is usually seen in children and young adults. It is often triggered by a streptococcal throat infection.
Erythrodermic psoriasis (erythroderma)
A serious, but rare, complication of psoriasis is erythroderma. It occurs when individual plaques are replaced by generalized reddening and scaling of the entire body. This is a severe and dangerous form of psoriasis that may disrupt the body’s temperature regulation and cause kidney and heart problems. This is one of the few emergencies involving skin conditions. If you suffer from this your doctor will admit you to hospital.
Pustular psoriasis
Identified by pustules or fluid filled ‘bubbles’ that develop on plaques, this form of psoriasis falls into two categories:
Palmoplantar psoriasis: Red, scaling plaques with small pustules that develop on the palms and the soles of the feet. The pustules are 1 - 10mm (pin- to dime-sized) in diameter and are often painful, interfering with daily functioning. It predominately affects women.
Generalized pustular psoriasis: Marked by a general reddening and inflammation of the skin with sheets of small pustules merging into larger sheets. This is a serious and potentially life-threatening illness that can severely disrupt the skin’s function.
Scalp psoriasis
Scalp psoriasis manifests itself through scaling and flakes of the scalp, often particularly affecting the hair margins.
Psoriatic Arthritis
Approximately 10 to 30 percent of people with psoriasis have psoriatic arthritis, which causes joint stiffness, pain and swelling – and, frequently, nail changes. Psoriatic arthritis generally affects the fingers and toes, but it can involve the wrists, lower back, knees and ankles. Psoriatic arthritis can be a serious disease, with a large percentage of patients reporting that their symptoms limit their work or home activities.
Psoriatic arthritis usually appears between the ages of 30 and 50. Its symptoms usually include at least one of the following:
- Pain in one or more joints
- Movement that is restricted by pain in the joint or surrounding areas
- Morning stiffness
- Eye pain or redness
Because there is no laboratory test for psoriatic arthritis, people with psoriasis and joint pain may want to consult a specialist in joint diseases, called a rheumatologist, to evaluate their symptoms. Other joint diseases such as rheumatoid arthritis, gout, and Reiter’s syndrome all may be confused with psoriatic arthritis.
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