While many people have experienced a skin issue or two in their lifetime—a random acne breakout, an itchy rash from too-tight pants, or even a funky lookin’ yellow toenail—most of us don’t automatically think of psoriasis when something out of the norm crops up. “Often times patients will come into the office with a skin rash and not know what’s going on,” says Suzanne Friedler, MD, a dermatologist in New York City.
Psoriasis is a chronic disease that develops when a person’s skin cells grow too quickly (they form in days rather than weeks) due to faulty signals from the immune system. The body doesn’t shed these cells, so they pile up on the surface of the skin which causes patches of psoriasis to appear.
“Psoriasis can present differently in different patients,” says Dr. Friedler. Sometimes psoriasis comes on quickly and is very apparent, and other times it shows up in more subtle ways, looking similar to other skin conditions. Some patients will notice a sudden psoriasis outbreak and seek medical attention right away, and others will have small plaques for years, and not think to see a doctor until it develops into something larger, says Dr. Friedler.
So how do you know if your skin rash or itchy scalp could actually be psoriasis? “If you have a rash that’s not going away with therapies that you’re using over-the-counter, it’s a good idea to see your dermatologist,” says Dr. Friedler.
Take note of these common skin conditions that may actually be psoriasis, so you know when it’s time to make an appointment with your derm.
You think it’s a rash, but … it may be plaque psoriasis. “The most common symptom of psoriasis is red, flaky sometimes itchy skin,” says Dr. Friedler. Plaque psoriasis often appears as raised, red patches covered with a silvery white buildup of dead skin cells.
You think it’s dandruff, but … it may be scalp psoriasis. “If you have a very severe case of dandruff, flaky, itching, [or] really thick scales on your scalp, it might not be regular dandruff, it might be psoriasis,” says Dr. Friedler. Unlike dandruff, which are dry skin flakes, scalp psoriasis causes a silvery sheen and dry scales on the scalp. Scalp psoriasis may also cause skin to crack and bleed, and may lead to hair loss.
You think you just need a manicure, but … it could be a sign of psoriasis or psoriatic arthritis. “Psoriasis can often be mistaken for a nail fungus,” says says Dr. Friedler. “Often psoriasis will cause separation of the nail bed from the nail plate, causing yellowish oil drop spots to form on the toenails, or fingernails to form with ridges or pits.”
These changes in the nails are also a sign of psoriatic arthritis (PsA), a form of arthritis that affects some people with psoriasis. If you have psoriasis, you have a 10 to 30% chance of developing psoriatic arthritis.
You may think you have athlete’s foot but … it could be plaque psoriasis. Athlete’s foot, an infection caused by a fungus, and plaque psoriasis can share many similar symptoms, like itching, burning, and cracked, scaly skin. Athlete’s foot most often affects the space between your toes, while plaque psoriasis can appear anywhere on your feet. “If you think you have athlete’s foot, a rash on your feet that doesn’t seem to go away with an antifungal medication, that also could be psoriasis,” says Dr. Friedler.
You think you’re allergic to your deodorant, but … it may be inverse psoriasis. Inverse psoriasis shows up as very red lesions in body folds, such as behind the knee, under the arm, or in the groin. “In those areas, psoriasis will appear red and shiny,” says Dr. Friedler. “Sometimes it can be confused with an allergy from your deodorant.”
You think it’s a STD, but … it could be inverse psoriasis. Inverse psoriasis can cause itchy red lesions to form in the groin area, which can mimic symptoms of certain STDs or jock itch an infection of the groin area caused by a fungus. “When psoriasis forms in the groin folds, patients may mistake it for a STD, but it’s not,” says Dr. Friedler.
If you suspect you have psoriasis, get it checked out by a dermatologist sooner rather than later. There are many treatments and lifestyle changes to help heal your psoriasis. “Seeing your dermatologist can help your skin get better as quickly as possible,” says Dr. Friedler.