Psoriasis is a chronic systemic condition that can affect the skin and joints. An individual with psoriasis usually presents with red, thick, scaly plaques of skin. These plaques appear when an individual’s immune system signals skin cells to increase their rate of division. New skin cells build up quicker than the old cells can be shed, causing the thick plaques of skin to form. An individual’s finger nails and toenails may also be affected. In addition, individuals suffering from psoriasis of the skin can also have psoriatic arthritis. Psoriatic arthritis is characterized by pain, stiffness, and swelling in the joints.
There are five different presentations of psoriasis and individual that is affected by psoriasis may experience one or more of these types on any area of the body.
- Plaque psoriasis, the most common form, presents as red, scaly, patches that thicken and are eventually referred to as plaques (elevated patches). “Scaly” refers to a silvery-white appearance on top of the patches.
- Guttate psoriasis presents as many small, red, scaly, plaques, which typically appear on an individual’s abdomen, chest and back. It is frequently preceded by an upper respiratory infection.
- Inverse psoriasis affects the skin folds: armpits, between the thigh and groin, between the buttocks, and under the breasts. It appears as well-defined, smooth, red, patches.
- Pustular psoriasis presents as scaly plaques covered with pustules. Pustules are red bumps on the skin that are filled with pus due to the accumulation of white blood cells.
- Erythrodermic psoriasis is an extreme form of psoriasis that can occur when an individual on strong oral or injectable systemic medication for their psoriasis suddenly stops taking their medication. This may be accompanied by systemic symptoms, such as malaise and fever.
Psoriasis is treated on a case by case basis. Topical creams or ointments are prescribed for mild to moderate outbreaks, while oral medication or systemic medication may be prescribed for a moderate-severe case. In severe cases, a biologic medication may be prescribed to target the immune defect that causes rapid skin growth and plaques.