Psoriasis presents differently in every patient.
When it comes to psoriasis—don’t judge the skin by its cover. Psoriasis may look like a cosmetic problem, but it’s much, much more than that. (Learn about other common psoriasis myths here.)
Psoriasis is an autoimmune disease, and the most prevalent one in the United States at that. Of the 7.5 million Americans who suffer from psoriasis—approximately 2.2 percent of the population—about 60 percent report that the condition significantly affects their quality of life.
Psoriasis is a chronic condition that develops when a person’s skin cells grow too quickly (forming in a few 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. Learn more about psoriasis and its symptoms here.
The symptoms of psoriasis depend on the type of psoriasis you have. “Psoriasis doesn’t have a classic presentation in every patient,” says Suzanne Friedler, MD, a dermatologist in New York City. “That’s why if you have a rash that’s difficult to identify, you should see your dermatologist.”
Understanding the Psoriasis Types
There are five different types of psoriasis: plaque, guttate, inverse, pustular, and erythrodermic. These different types can appear alone, or with another type.
1. Plaque psoriasis is the most common form. “It appears with red, well-defined plaques that may be present on the elbows, knees, lower back and scalp,” says Friedler. The plaques are often raised, red patches covered with a silvery white buildup of dead skin cells. They’re often itchy and painful, and they can crack and bleed.
2. Guttate psoriasis is the second most common form of psoriasis. About 10 percent of people who get psoriasis develop guttate psoriasis. “Guttate psoriasis can look like little red dots scattered all over your body, and some of them will have scales on them,” says Friedler.
Guttate psoriasis often starts in childhood or young adulthood, and may be triggered by a strep infection. “Because guttate psoriasis is often preceded by a strep infection, it is highly responsive to antibiotics,” says Friedler.
3. Inverse psoriasis is different from other types of psoriasis in that it doesn’t present with a thick, white scale. Inverse psoriasis shows as red lesions that are sometimes smooth and shiny. They often show up in body folds, like behind the knee, under the arm, or in the groin. “Psoriasis in these areas are often mistaken as a fungal infection or some other condition,” says Friedler.
4. Pustular psoriasis is when a person has white pustules (blisters of non-infectious pus that contain white blood cells) surrounded by red skin. “[Pustular psoriasis] can appear anywhere on the body, but it’s most common on the palms and soles [of the feet],” says Friedler.
5. Erythrodermic psoriasis is rare, but it’s also the most severe form of psoriasis. It causes widespread, fiery redness that covers most of the body. It’s itchy, painful and can cause the skin to come off in sheets.
Erythrodermic psoriasis occurs in about 3 percent of people who’ve had psoriasis during their lifetime. “It can be life-threatening, so if you have this type of psoriasis you should seek medical attention immediately,” says Friedler.
“Psoriasis can look different from patient to patient, and even in the same patient in the course of their lifetime,” says Frielder. “If you have a new rash, or a rash that’s changing, it might be psoriasis. Speak to your dermatologist to get the best answer.”
Dr. Friedler is a dermatologist and clinical instructor at The Mount Sinai Hospital and St. John's Episcopal Hospital.
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Psoriasis doesn't have a classic
presentation in every patient.
00:00:06,312 --> 00:00:08,838
That's why if you have a rash
that's difficult to identify,
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it's important to see your dermatologist.
00:00:10,694 --> 00:00:15,678
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So there are five different types of
psoriasis, there are plaque, guttate,
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erythrodermic, inverse and pustular.
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They can appear alone or in combination.
00:00:25,223 --> 00:00:28,200
Plaque psoriasis is the most
common type of psoriasis.
00:00:28,200 --> 00:00:32,730
It appears with red, well-defined plaques
that may be present on the elbows, knees,
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lower back, scalp, or belly button.
00:00:35,420 --> 00:00:38,740
Guttate psoriasis is the second
most common form of psoriasis.
00:00:38,740 --> 00:00:40,885
It appears in about 10% of patients.
00:00:40,885 --> 00:00:44,295
Guttate psoriasis can look like little
red dots scattered all over your body.
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Some of them will have scale on them.
00:00:46,235 --> 00:00:50,071
Because guttate psoriasis is often
preceded by a strep infection,
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it is highly responsive
to oral antibiotics.
00:00:52,708 --> 00:00:57,438
Inverse psoriasis is different from other
types of psoriasis in that it doesn't
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contain that white,
thick scale that characterizes most forms.
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It usually appears as smooth red patches
in skin folds, such as the underarms,
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behind the knee, or in the groin folds.
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Psoriasis in these areas
are often mistaken for
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a fungal infection or
some other condition.
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Pustular psoriasis is a type of psoriasis
characterized by small white pustules
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with surrounding redness.
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This can appear anywhere on the body, but
it's most common on the palms and soles.
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Erythrodermic psoriasis covers
the entire body with redness.
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This is the most severe type.
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It can be life-threatening, so
if you have this type of psoriasis,
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you should seek medical
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Psoriasis can look different
from patient to patient, and
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even in the same patient over
the course of their lifetime.
00:01:40,380 --> 00:01:44,500
If you have a new rash or a rash that's
changing, it might be psoriasis.
00:01:44,500 --> 00:01:50,229
Speak to your dermatologist
to get the best answer.
00:01:50,229 --> 00:01:52,080
About Psoriasis. Rosemont, IL. National Psoriasis Foundation. (Accessed on October 14, 2021 at https://www.psoriasis.org/about-psoriasis)Psoriasis. Chicago, IL. American Academy of Dermatology. (Accessed on October 14, 2021 at https://www.aad.org/public/diseases/scaly-skin/psoriasis#overview)