Types of Psoriasis

• Plaque psoriasis – About 80 percent of people with psoriasis have this type, which shows up as raised, thickened patches of reddish skin, covered by silvery-white scales, called plaques. These plaques usually show up on the elbows, knees, scalp, chest and lower back, but can appear anywhere. Patches can be small, or quite large.
• Guttate psoriasis – This type affects about 10 percent of people. It’s more likely in children and young adults who are prone to streptococcal infections (such as strep throat). It shows up as small red spots, usually on the trunk of the body, arms and legs. It can come on quickly, and then go away, never to reappear again, or may flare up for a number of years.
• Pustular psoriasis – Only about 5 percent of people get this kind, which often is triggered by infections, sunburn, or certain medications. This type involves red, swollen skin dotted with pus-filled white spots. It can be localized – confined to certain areas – or widespread.
• Localized – The white spots most often appear on the palms of the hands and soles of the feet, and can make walking or using the hands painful. The spots dry up and often turn brown.
• Generalized – When the white spots and red skin are widespread – appearing on more than just the hands and feet – it’s known as generalized pustular psoriasis, which is rare, but can be life-threatening. It can be caused by a number of things, including strep throat, suddenly stopping steroids, becoming pregnant, and taking certain medications, such as lithium or oral cortisone. In addition to the spots, a person may have fever, chills, loss of appetite and muscle weakness.
• Inverse psoriasis – This type of psoriasis involves red, inflamed, shiny and smooth plaques that occur in the folds of the skin, such as the armpits, the genitals, the buttocks and under the breasts. It is uncommon, but can be severe and painful. It’s more likely to occur in overweight people.
• Erythrodermic psoriasis – This is the least common type, occurring in only 1 or 2 percent of people with psoriasis. Also called exfoliative psoriasis, it appears as severe redness and shedding over much of the body, making the skin look burned. It can occur suddenly, even in those who have never had psoriasis, and can be life threatening because the skin can no longer protect the person from heat, fluid loss and harmful bacteria. People with erythrodermic psoriasis often need to be admitted to the hospital so they can be stabilized. It can be triggered by many things, including:
• Stress
• Infection
• Alcoholism
• Some medications
• Suddenly stopping psoriasis medications such as cyclosporine or methotrexate

Psoriatic arthritis is a related condition that involves joint pain and can cause severe deformity that’s especially apparent in the fingers and toes. About 70 percent of people with this condition develop some form of psoriasis first. In addition to the pain and swelling of joints, it can affect the nails, which may discolor and pull away from the nail beds.

 

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