Psoriasis symptoms often mimic other common skin issues.
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.
Dr. Friedler is a dermatologist and clinical instructor at The Mount Sinai Hospital and St. John's Episcopal Hospital.
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Oftentimes patients will come into the office
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with a skin rash and not know what's going on.
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Psoriasis is a chronic skin condition
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where faulty signals from the immune system
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cause skin cells to form more rapidly than usual.
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That causes skin cells to be more immature,
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so they'll turn red and cause thick scales to form as well.
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Psoriasis can present differently in different patients.
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Some patients will get a severe outbreak
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of psoriasis right at the onset.
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And they often seek out medical attention very promptly.
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In other patients small papular plaque can develop
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and stay stable for many years
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before developing into something larger
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and causing the patient to seek out medical attention.
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The most common symptom of psoriasis
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is red, flaky, sometimes itchy skin.
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If you have a very severe case of dandruff,
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flaking, itching, really thick scales on your scalp,
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it might not be regular dandruff, it might be psoriasis.
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So psoriasis can often be mistaken for a nail fungus.
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Often psoriasis will cause separation
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of the nail bed from the nail plate,
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causing yellowish oil drop spots to form
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on the toenails or fingernails to form with ridges or pits.
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Also, if you think you have athlete's foot,
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you have a rash on your feet, that doesn't seem to go away
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with an antifungal medication, that also could be psoriasis.
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So psoriasis in the armpits and in the body folds
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has a special name called inverse psoriasis.
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In those areas, psoriasis will appear red and shiny.
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Sometimes it can be confused with
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an allergy to your deodorant.
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When psoriasis forms in the groin folds,
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patients may mistake it for an STD, but it's not.
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If you have a rash that's not going away
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with the therapies that you're using over the counter,
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it's a good idea to see your dermatologist,
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because your dermatologist can determine
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if this condition is psoriasis.
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Psoriasis has many treatments that can
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help your condition get better.
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So seeing your dermatologist for a quick diagnosis
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can help your skin get better as quickly as possible.
About Psoriasis. Portland, OR. National Psoriasis Foundation. (Accessed on April 3, 2021 at https://www.psoriasis.org/about-psoriasis)
Scalp Psoriasis: Signs and Symptoms. Rosemont, IL. American Academy of Dermatology Association. (Accessed on April 3, 2021 at https://www.aad.org/public/diseases/hair-and-scalp-problems/scalp-psoriasis#symptoms)
Athlete’s foot. Bethesda, MD. U.S. National Library of Medicine, MedlinePlus. (Accessed on April 3, 2021 at https://medlineplus.gov/athletesfoot.html)
Jock itch. Bethesda, MD. U.S. National Library of Medicine, MedlinePlus. (Accessed on April 3, 2021 at https://medlineplus.gov/ency/article/000876.htm)Psoriasis. Atlanta, GA. Centers for Disease Control and Prevention. (Accessed on April 3, 2021 at https://www.cdc.gov/psoriasis)