Psoriasis Types
Plaque Psoriasis
Plaque psoriasis is marked by raised, red, scaly patches called plaques. These plaques have well-defined edges, making them distinct from other types of skin inflammation. Typically, plaques are raised 2-3 millimeters, scaly, and vary in color based on skin type and location.
The scales may flake off easily, and if scratched, the surface becomes dull and opaque. Removing scales often reveals a thin membrane beneath, representing the final skin layers. Due to frequent shedding, plaque psoriasis can affect self-esteem and daily life as flakes may be visible on clothing or in places the person visits.
Where Plaque Psoriasis Commonly Appears
- Scalp: The scalp is a common site for psoriasis, although hair often makes it harder to see the lesions. These patches can extend slightly beyond the hairline and may have a yellowish tint.
- Intertriginous Areas: These are areas where skin rubs against skin, like armpits, groin, and between fingers. Plaques here appear shiny and reddish rather than dry.
- Inverse Psoriasis: Found on the inner folds of joints, this type can resemble atopic dermatitis with its small to medium-sized scales.
- Palmoplantar Psoriasis: Affecting the hands and feet, this form is challenging as the thickness of the skin in these areas makes it harder to treat.
Koebner Phenomenon: New psoriasis lesions can develop in areas of prior skin trauma, often appearing 1-2 weeks after the injury.
Guttate Psoriasis
Guttate psoriasis often affects children and young adults and may be the first sign of psoriasis. It appears as small, drop-like red spots across the body and may follow infections like strep throat. Unlike plaque psoriasis, it doesn’t cause as much scaling and may cause mild fever or fatigue.
Differentiation: Some skin conditions, like Psoriasis Rosea, are sometimes confused with guttate psoriasis, though their lesions tend to be larger and less common on the face.
Pustular Psoriasis
Pustular psoriasis is less common and typically appears after guttate or plaque psoriasis. It involves small, pus-filled blisters on red skin.
Triggers for Pustular Psoriasis:
- Pregnancy: Increased progesterone in late pregnancy may trigger pustules.
- Corticosteroids and Other Treatments: Some medications, UV exposure, and skin irritants may bring on pustular symptoms.
- Infections: Respiratory infections are a known trigger.
Patterns of Pustular Psoriasis:
- Zumbusch Pattern: A sudden outbreak of painful redness and pustules, often with fever.
- Annular Pattern: Round, pustule-bordered patches that may persist or spread for extended periods.
- Exanthematous Pattern: Sudden eruptions starting on hands and feet, spreading quickly.
Subtypes of Pustular Psoriasis
- Generalized Pustular Psoriasis (GPP): Also known as the Zumbusch pattern, GPP is a severe form with potentially serious effects and can be triggered by stress, hormonal changes, infections, or certain medications.
- Pustular Psoriasis During Pregnancy (GPPP): Occurs due to hormonal shifts.
- Annular Psoriasis (EACP): Characterized by ring-shaped red lesions with pustules, appearing suddenly and then receding.
- Palmoplantar Pustular Psoriasis (PPP): Affecting hands and feet, PPP is more common in smokers.
- Hallopeau Psoriasis: Triggered by trauma or infection, usually affects fingers or toes and involves pustules on a reddish base.
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