All psoriasis rashes are not alike. Several types of psoriasis exist — and while some features are distinct, you still might have trouble identifying them at first glance.
This article will talk about psoriasis types, cover general treatment options, and show you what each type of rash looks like.
Psoriasis is a chronic autoimmune condition. If you have psoriasis, it means your skin cells regenerate much faster than usual, causing them to build up. Anyone can get psoriasis, but it’s not contagious.
There are several types of psoriasis and, like other autoimmune diseases, they may involve flare-ups and periods of remission. You can even have more than one type.
Some common triggers for psoriasis are:
- certain medications
- infections or injury to the skin
- stress
- smoking or alcohol use
- skin friction or trauma
About 80 to 90 percent of people with psoriasis have plaque psoriasis, according to the National Psoriasis Foundation. This makes it the most common type of psoriasis.
A plaque psoriasis rash looks like raised patches of thick, inflamed skin. On light skin, it looks red and scaly, often with a layer of silver on top. On skin with more pigment, the plaques look purple, gray, or darker brown and tend to be thicker.
Plaques can develop anywhere but are most likely to appear on your:
- scalp
- elbows
- knees
- lower back
Plaques also tend to be symmetrical. For example, you’re more likely to have plaques on both knees or elbows than on just one side. Other symptoms include:
- itching
- irritation
- pain
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Inverse psoriasis rash looks like smooth, shiny patches. On light skin it tends to be bright red. On skin with more pigment, it may be more purple or dark brown. It doesn’t have the characteristic scaling of plaque psoriasis.
It appears in places where skin touches skin, so it may develop:
- in the armpits
- in the groin area
- under the breasts
- in deep skin folds
This type of psoriasis can become even more irritated by perspiration (sweating) or friction (rubbing).
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You can spot this type of psoriasis rash by small, raised round spots called papules. They sometimes have a scaly appearance. The spots might look red on light skin and purple or brown on skin with more pigment.
Guttate psoriasis can start at any age. For most people, though, it starts in childhood or adolescence. It can develop after an infection, such as strep throat or tonsillitis.
It’s most likely to develop on the limbs and torso, though some people get it on the scalp, face, or ears.
Psoriasis can appear anywhere on the body. It can develop in just one area, or it can show up in several. For example, there’s:
- scalp psoriasis, which can lead to hair loss
- nail psoriasis, which can cause nails to pit, crumble, or separate from fingers or toes
- genital psoriasis, which is not sexually transmitted but can make sex uncomfortable
Plaque, inverse, and guttate are the most common types. Others include:
Pustular psoriasis
Pustular psoriasis is most likely to develop on the hands and feet. The pustules are scaly white blisters filled with pus. The skin around the painful blisters may be red and inflamed and may crack easily.
Erythrodermic psoriasis
Erythrodermic psoriasis is a severe skin condition. The main symptom is a dry rash that covers much of your body.
On lighter skin, the rash looks red. On skin with more pigment, it may look more purple or gray. It can look like skin that has been burned.
Other symptoms may include:
- shedding
- severe pain
- itching
Medical emergencyErythrodermic psoriasis can also cause a chemical imbalance in your body and is a life threatening condition. Call 911 or go to the nearest emergency room if you quickly:
- develop a rash
- are shedding skin
- have severe pain
- experience itchiness
Possible complications of this condition include:
- dehydration
- infection
- hypothermia
- swelling of the legs
- rapid heartbeat
- heart failure
- malnutrition
Generalized pustular psoriasis
Generalized pustular psoriasis is another uncommon but serious skin condition, also known as von Zumbush psoriasis.
It starts out looking like a widespread dry rash. Blisters appear within a few hours, then fill with pus. As the blisters dry out, they peel and leave a smooth surface. Over the course of a few days or weeks, new blisters may erupt, forming layers upon layers.
Medical emergencyGeneralized pustular psoriasis is life threatening and requires emergency medical care. Call 911 or go to the nearest emergency room if you experience the symptoms above as well as any of the following:
- fever
- chills
- hypothermia
- dehydration
- headache
- rapid pulse
- swelling of the legs
Each type of psoriasis has its own look. But it can be difficult to differentiate one type from another or from other kinds of rashes.
Take a look through these photos to get a better idea what each type of psoriasis rash looks like.
Many other rashes can look similar to psoriasis. Among them are:
- dermatitis
- eczema
- jock itch
- lichen planus
- onychomycosis
- pityriasis rosea
- pityriasis rubra pilaris
- seborrheic dermatitis
It can be difficult to identify a rash on your own, so it’s best to see a doctor for diagnosis and treatment.
Treatment for psoriasis depends on:
- where the rash appears
- how severe it is
- other underlying conditions, such as psoriatic arthritis
Although skin color can affect the appearance of the rash, it doesn’t affect treatment.
Topicals
Most people start treatment with topical creams and ointments applied directly to the skin. There are many types and strengths of topicals. So, if you try one that doesn’t work for you, your doctor can switch you to another.
These topicals may include:
- emollients
- corticosteroids
- vitamin D creams
- calcineurin inhibitors
- coal tar
- dithranol
- retinoids
If you have scalp psoriasis, treatment may include special shampoo.
Light therapy
In most cases, a dermatologist can perform light therapy in an office setting. This may involve UVA, UVB, or combination phototherapy. It can also involve an excimer laser.
Systemic treatment
When psoriasis is severe or other treatments aren’t helping, systemic treatments may be helpful. Systemic treatment refers to medications that spread throughout the body.
Some of these are biologics like:
Others are non-biologics, such as:
Hospitalization
Treatment for erythrodermic psoriasis and generalized pustular psoriasis may involve hospitalization.
Psoriasis is a chronic condition of flare-ups and remissions. There’s no cure, but some people are able to identify and avoid things that trigger flare-ups.
Some home remedies for psoriasis include:
- Develop a good skin care routine. This should include daily use of moisturizers for sensitive skin or specifically for psoriasis.
- Do your best to avoid scratching, which can lead to broken skin, bleeding, and infection.
- Use a humidifier to help avoid dry skin.
- Avoid fragrances and other skin irritants.
- Maintain a nutritious, balanced diet and take supplements as advised by your doctor.
- Try to reduce stress when possible.
- Drink alcohol only in moderation.
- If you smoke, try to quit. Quitting can be difficult, but a doctor can help create a cessation plan that works for you.
See a doctor if you have a rash that you can’t identify. Getting the right diagnosis is crucial to finding a treatment that works for you.
Once you have a diagnosis, let your doctor know if it’s not working or if you have new symptoms. This way, they can advise you on how to modify your treatment plan accordingly.
Psoriasis rashes all look different, depending on the type of psoriasis you have, where it appears on your body, and what skin tone you have. Treatment should be tailored to each individual situation, based on psoriasis type, location, and severity.