Plaque psoriasis is characterized by itchy, scaly patches of skin that often appear on knees, elbows, and lower back. It can be managed over time, but there’s currently no cure.
Chronic plaque psoriasis is an inflammatory disease triggered by a malfunction of the immune system. The most obvious signs of plaque psoriasis are dry, flaky patches of skin, but this condition can cause a number of problems you can’t easily see, too.
This article will review what plaque psoriasis is, how it’s diagnosed and treated, and what to expect in terms of symptoms.
Psoriasis is a chronic, inflammatory autoimmune disease.
There are many forms of psoriasis that can appear with a range of symptoms and severity, but chronic plaque psoriasis is the most common variety. Plaque psoriasis affects 80% to 90% of people with the disease.
Different forms of psoriasis are characterized by the type of skin lesions that can appear, as well as the areas of the body they impact.
All varieties of psoriasis are chronic. Although some cases may improve or go into remission with treatment, psoriasis is not currently curable.
Your primary care physician may be the first to diagnose you with chronic plaque psoriasis, but different forms of psoriasis might also be managed by a dermatologist or rheumatologist.
The most common way for your healthcare professional to diagnose chronic plaque psoriasis is with a visual examination. Well-defined dry or scaly patches are a hallmark sign of plaque psoriasis.
Additional testing may be done to officially confirm your diagnosis or to rule out any
- atopic dermatitis
- contact dermatitis
- lichen planus
- secondary syphilis
- mycosis fungoides
- tinea corporis
- pityriasis rosea
The most common test done to help differentiate between these conditions is a skin scraping or skin biopsy, where a sample of your skin will be examined with a microscope to help identify any other potential causes of irritation or infection.
Different forms of psoriasis, on the other hand, are most often diagnosed after careful observation, noting specifically the different ways lesions might appear in different forms of the disease.
The primary symptom of chronic plaque psoriasis is the appearance of scaly skin lesions with clearly defined borders. These lesions often appear symmetrically on each side of the body, starting as small papules and eventually merging into larger plaques.
Other symptoms that can develop with the appearance of these plaques include:
- itching
- redness
- a flattened texture
- silvery to white scales
In many cases, lesions that appear with plaque psoriasis will bleed if the scales are peeled away (Auspitz sign), and lesions often appear where the skin has been injured (Koebner phenomenon).
Plaque psoriasis can appear on many areas of the body, but it’s most common on the knees, elbows, and lower back. Plaques can appear anywhere on the skin, including:
- scalp
- nails
- skin folds
- palms
- soles
There are many treatments available, and some of these treatments may be used in combination with each other. Topical treatments are usually the first step in treating plaque psoriasis and may include:
- topical steroid creams, including mometasone (Elocon) and clobetasol (Temovate)
- vitamin D derivatives like calcipotriene (Dovonex)
- topical retinoids like tazarotene (Tazorac)
- topical immunosuppressants, including tacrolimus (Prograf) and pimecrolimus (Elidel)
- anthralin (Anthra-Derm) or coal tar
- phototherapy with UV light
There are also a number of systemic medications that are taken orally or by injection, including:
- acetretin (Soriatane)
- adalimumab (Humira)
- cyclosporine/ciclosporin
- etanercept (Enbrel)
- infliximab (Remicade)
- methotrexate (Rheumatrex)
- mycophenolate (CellCept), though this one may not be widely prescribed as it’s not FDA-cleared for this purpose and is considered “off-label”
- ustekinumab (Stelara)
- apremilast (Otezla)
- Secukinumab
- Lxekizumab
- Risankizumab
Your healthcare team might also suggest a number of diet or lifestyle changes that may help improve your plaque psoriasis, including:
- quitting smoking
- reducing stress
- acupuncture
- psychotherapy
- vitamin D
- other dietary supplements
Plaque psoriasis, as well as other forms of psoriasis, are chronic and cannot be cured.
There are triggers like stress or infections that can cause even a well-managed case of psoriasis to flare up, and there are also medications and treatments that can put the disease into remission.
But no matter what treatments are used or how well you’re able to avoid triggers, you won’t be able to cure your psoriasis completely.
Chronic plaque psoriasis can be treated with a variety of creams and oral medications, phototherapy, and even injections. Lifestyle changes may also help.
Often characterized by itchy, scaly patches of skin that most often appear on the knees, elbows, and lower back, plaque psoriasis can be managed over time. But it’s not currently curable.