What is Psoriasis?

If you have psoriasis already, I am sure you already know what it is, but if you’re in any doubt here is a rundown of the different types of psoriasis and a brief description of each one.

Psoriasis is an inflammatory skin disease where the skin cells reproduce much faster than normal - every 4 days instead of every 21 days. There is no cure for this horrible disease, but some people do get into remission.  Here are different types ....

Plaque

This is the most common type of psoriasis. The skin reproduces so quickly that red scaly plaques are formed. These can be extremely itchy, sore and sometimes weep. You can easily see and feel where each plaque starts and finishes, and the usually have a silvery appearance as the layers of skin cells build up. Psoriasis can start at any age, but it seems to appear most often between the ages of 18 to 30, and again around the ages of 50 to 60.  Psoriasis affects approximately 2% of the population - equally between men and women.

Guttate

From the latin 'guttae' meaning 'drops', guttate psoriasis looks like small red or pink spots on the skin about a centimetre in diameter or darker patches on darker skin. The stomach, chest and back are common areas for guttate psoriasis to appear, but it can affect the face and arms and legs.  Again, this can occur at any age but is more common in children and younger adults. The patches can be scaly and itchy in some, but others may not even notice them. Often guttate psoriasis follows a streptococcal throat infection. It can clear by itself in a few weeks or months but may return after more throat infections. It can also develop into other types of psoriasis.

Inverse or Flexural Psoriasis

This type appears in sensitive areas of the body such as the face, armpits, genitals, skin folds (such as underneath the breasts).  This is less scaly and more red and shiny in appearance. Obviously, in intimate areas this can cause extreme embarrassment (which can make the rash worse), and it can be mistaken for other types of skin infections as it doesn’t typically look like psoriasis.

 Scalp

Plaque psoriasis can often affect the scalp. It can form very thick scaly patches around the ears, on the back of the head just above the neck, and on to the forehead. As you can imagine the hair can be affected, but normal growth returns as the scalp is treated. Scalp psoriasis is difficult to hide as it causes severe flaking, and so can be very emotionally distressing - especially if you want to go to the hairdresser. It can be very itchy and sore just as plaque psoriasis is on other areas of the body.

Pustular - Generalised

This is a rare condition that affects more women than men. Small blisters filled with pus appear on the skin, although they are not caused by any infection. This can be a very serious so should be seen by a medical professional immediately. As with any autoimmune condition there can be a number of causes. It can be triggered by reducing steroids too quickly - another reason for tapering off steroids very slowly, again under medical supervision.

Pustular PPP

PPP stands for Palmoplantar Pustulosis and affects the palms of the hands and soles of the feet. Again, pus filled blisters form with dry cracked skin around them. This is thought to be an autoimmune condition where the body attacks the sweat glands specifically in these areas. PPP seems to affect more women than men and it is more common not to have any other form of psoriasis with this type.  Although I have had psoriasis on the palms of my hands at the same time as having plaque psoriasis.  I didn’t seem to have the pustules as it was more cracked and flakier…… nice!

Nail Psoriasis

This is very common and can affect at least half of those with any other type of psoriasis. Although you can develop nail psoriasis on its own. It is also extremely common among those with psoriatic arthritis. The nails can become discoloured, thickened pitted or brittle and break easily. The nail can also become detached from the nail bed.  It can affect nails on both the fingers and the toes.  

Psoriatic Arthritis

As the name suggests this type of psoriasis affects the joints, but it also affects tendons and ligaments which makes it different to other types of arthritis.  The most affected joints are the knees, hands, feet, lower back and heels, but because tendons and ligaments are affected people may be misdiagnosed with tennis elbow or tendonitis.  Again, no firm rules about psoriatic arthritis (PsA).  Some people get it without having psoriasis, but most people get it after having the skin version first. 

The way forward to dealing with psoriasis, or an other health issue for that matter, is to look for the root cause. Just putting something on your psoriasis is not the answer, although it will be one of the first things to do to start taking control of your skin. See my post on tips to manage your flares.