Photos of the Types of Psoriasis
The Many Types of Psoriasis
For much of the public, psoriasis is an uncomfortable, unsightly skin condition. However, for those with psoriasis, it means an often painful and intensely itchy chronic autoimmune disease that appears on the skin. According to the National Psoriasis Foundation, psoriasis is the most common autoimmune disorder in the United States, affecting up to 7.5 million people (NPF, 2012).
There are five official types of psoriasis: plaque, guttate, inverse, pustular, and erythrodermic, psoriasis. There are also subcategories of psoriasis types, which appear differently depending on where it is located on the body. See what they look like by viewing the pictures in this educational slideshow.
Plaque psoriasis is the most common form of psoriasis, affecting 80 percent of people with psoriasis (NPF, 2012). It often appears on the elbows, knees, lower back, and scalp. It is characterized by thick red patches of skin, often with a silver or white layer of scale.
Some people inherit genes linked to psoriasis, but most develop the condition suddenly due to a number of psoriasis triggers. There is no single cause or cure for psoriasis.
Guttate psoriasis appears in small red spots on the skin. It is the second most common form of psoriasis. The spots often appear on the torso and limbs, but they can also occur on the face and scalp. They are usually not as thick as plaque psoriasis, but they may develop into plaque psoriasis over time.
According to the National Institutes of Health, this form of psoriasis often occurs during childhood or young adulthood, often after a “trigger” of strep throat, stress, skin injury, infection, or taking medication (NIH, 2011). Guttate psoriasis often resolves for long periods of time after a short course of treatment.
Flexural or Inverse Psoriasis
Flexural or inverse psoriasis often appears in skinfolds (under the breasts, in the armpits, or in the groin area). It is very red and often shiny and smooth. Most people with inverse psoriasis also have a different form of psoriasis in other places on the body.
The sweat and moisture from skinfolds keeps this form of psoriasis from shedding skin scales, and the skin-on-skin contact can make inverse psoriasis very irritating. A variety of topical treatments are available and effective for inverse psoriasis.
Pustular psoriasis is characterized by white pustules surrounded by red skin. The pus inside the blisters is noninfectious. Scaling also occurs. There are three kinds of pustular psoriasis: von Zumbusch, palmoplantar pustulosis (PPP), and acropustulosis.
Each of the three forms of this type of psoriasis have different symptoms and severity. Pustular psoriasis may affect isolated areas of the body, like the hands and feet, or cover most of the skin’s surface. Some people experience cyclic periods of pustules and remission. Pus-filled blisters require medical attention.
Although not an official category of psoriasis, nail psoriasis is a manifestation of psoriasis that affects up to half of all individuals with psoriasis elsewhere on the body (Kahl, Hansen, & Reich, 2012). The condition can often be confused with fungal infections and other infections of the nail.
Nail psoriasis can cause nail pitting, grooves, discoloration, loosening or crumbling of the nail, thickened skin under the nail, and colored patches or spots under the nail (Tan, Chong, & Tey, 2012). There is no cure for psoriatic nails, but some treatments may improve the health and appearance of nails.
Several types of psoriasis may appear on the scalp. Some may cause severe dandruff, while others can be painful, itchy, and very noticeable at the hairline. It can extend to the neck, face, and ears, and it may be in one large patch or many smaller patches.
In some cases, scalp psoriasis can make even regular hair hygiene difficult. Excessive scratching can cause hair loss and scalp infections, and the condition can be a source of social stress. Topical treatments may be effective, but they may require an initial two months plus permanent regular maintenance.
Psoriatic arthritis is a painful and physically limiting condition affecting up to 30 percent of those with psoriasis (NPF, 2012). It can affect many joints and often becomes quite severe in the hands. While there is no cure for psoriatic arthritis, some people achieve remission with arthritis treatments and exercises.
According to the National Psoriasis Foundation, erythrodermic psoriasis is the rarest form of psoriasis, and it is very serious (NPF, 2012). This form of psoriasis looks like severe burns to the skin. It may cover large portions of the body, and exfoliation often occurs in larger pieces than the small scales typical to most psoriasis. It is very painful and may require hospitalization.
Erythrodermic psoriasis can occur with pustular psoriasis or develop from widespread, poorly controlled plaque psoriasis. It can also be caused by a bad sunburn, infection, alcoholism, significant stress, or abrupt discontinuation of a systemic psoriasis medicine.
Although there is no true cure for any form of psoriasis, remission and significant healing is possible. However, according to the Mayo Clinic, treatment options range from traditional pharmaceuticals—like topical corticosteroids—to diet-based and natural remedies, such as Dead Sea salt and mud treatments (Mayo Clinic, 2011).
Physicians may slowly build up to the most effective treatment plan for an individual’s psoriasis symptoms. Most start with a topical or light therapy treatment and only progress to systemic medications if the first tries are unsuccessful.
Psoriasis can dramatically impact the lives of those with the condition. Because of a lack of public awareness, many people fear the condition is contagious and may shun those with psoriatic skin problems.
Thanks to the advocacy work of dozens of psoriasis activists and organizations, psoriasis is slowly gaining the attention it deserves. Through public education, awareness activities, and extensive research, every form of psoriasis may one day be accepted and curable