Psoriasis is an autoimmune disease that affects your skin. An autoimmune disease is a condition in which your immune system attacks your body. In the case of psoriasis, your skin cells multiply too quickly.
The “revved up” life cycle of skin cells causes a variety of symptoms that you’ll see on your skin. The symptoms range from scaly, silvery lesions and red patches to areas of pus-filled sores. The symptoms depend on the type of psoriasis you have. Inverse psoriasis is one type of psoriasis.
What is inverse psoriasis?
Inverse psoriasis is a form of the disease that affects skin folds. These are areas of your body where skin rubs against skin. Inverse psoriasis can occur under your arms, under a woman’s breasts, or in the groin or inner thigh area.
Inverse psoriasis is also called intertriginous psoriasis. People who have inverse psoriasis often have another form of the disease, such as plaque psoriasis, on other parts of their body. While raised lesions of dry, scaly skin — the hallmark sign of plaque psoriasis — often covers large sections of your body, inverse psoriasis tends to be limited to smaller patches.
Psoriasis on the body. Photo: iStockphoto
Inverse psoriasis often appears in skinfolds such as the underarm area. Photo: DermNet New Zealand
Compared to the scales and spots associated with other types of psoriasis, inverse psoriasis appears as a smooth, shiny, and red rash. Photo: DermNet New Zealand
This lightbox uses UVB rays to slow the growth of skin cells in people with psoriasis. Photo: DermNet New Zealand
Inverse psoriasis is known for its red, shiny, smooth rash. Unlike the scales, pustular spots, and crusting skin associated with other forms of psoriasis, the rash caused by inverse psoriasis is neither raised nor dry.
Inflamed patches of skin are moist to the touch. You may feel irritation, itching, or both in areas that are affected by inverse psoriasis. You’re also more likely to develop a yeast infection in the skin folds due to the moist environment. The red lesions generally cover very large areas within your skin folds.
Inverse psoriasis is caused by an abnormality in your immune system, just like other autoimmune diseases. However, moisture (in the form of sweating) and friction are secondary causes of this particular type of psoriasis. If you’ve got psoriasis and are overweight, you’re more likely to develop inverse psoriasis. The extra body weight produces excess skin and deeper skin folds.
There are several different treatment methods available for inverse psoriasis:
Topical creams rather than ointments, which are types of medication that you rub into your skin, are the first-line treatment method for inverse psoriasis. The goal of treatment is to reduce inflammation and discomfort in these sensitive areas. Because the skin folds are so sensitive, medications must be used carefully.
Steroid creams can successfully reduce inflammation, but can also cause the skin to become thinner and more sensitive. If you’re prescribed a topical treatment, your doctor will monitor your progress and adjust the dosage if there are signs of skin thinning. You’ll usually use topical medicines in the morning after you shower and once again before bedtime.
Alternatives to topical steroids are topical calcineurin inhibitors, tacrolimus, and pimecrolimus, which will stop the body’s immune system from producing substances that may cause skin disease.
Infected inverse psoriasis treatment
Because inverse psoriasis is prone to yeast and fungal infections, your doctor may dilute topical steroids and add anti-yeast and anti-fungal agents.
Phototherapy is a treatment option for people with moderate to severe inverse psoriasis. Phototherapy is the medical term for light therapy. A form of ultraviolet light called UVB rays can effectively slow the growth of skin cells in some people with psoriasis.
Treatment with phototherapy involves using a light box that produces artificial UVB rays for a specified amount of time each session. The National Psoriasis Foundation notes that, with phototherapy, your psoriasis might temporarily worsen before it gets better. Let your doctor know of any concerns about your rashes during light therapy treatment.
If your inverse psoriasis isn’t getting better with topical medications and phototherapy, your doctor might prescribe systemic drugs. One type of systemic drug is a biologic, and is a type of medication that changes the way your immune system works. Biologics use proteins to block the response of your immune system so it won’t attack your body as much.
If biologics are used as a treatment, your doctor will give you an injection or intravenous infusion of biologic drugs on a regular schedule. You might also be directed to continue with phototherapy or topical treatments at the same time.
The symptoms of inverse psoriasis can be very uncomfortable. Take steps to increase your comfort levels, both physically and emotionally. Wear clothing that lets your skin breathe. Cotton and other natural fibers are soft against the skin. Loose tops won’t rub against your sore skin and can help prevent moisture from getting trapped in your skin folds. You can also powder your affected areas to absorb moisture with corn starch, baking soda, or zinc oxide. Try out different styles of dress to determine what works best for you as you treat the condition.