Psoriasis affects roughly 7.5 million Americans, and the National Psoriasis Foundation states that it is the most common autoimmune disorder in the United States. There are five main types of this skin condition:
Plaque
This is the most common type of psoriasis and affects 80 percent of psoriasis patients. It usually appears on the scalp, lower back, knees, and elbows. Patients will have thick red skin patches that are often accompanied by silver or white scales.
Guttate
The second most common form of psoriasis takes the form of small red spots on the skin, which are most likely to appear on the limbs or torso but can also appear on the scalp or face. Although the spots are not as thick as the spots seen in plaque psoriasis, guttate psoriasis can eventually develop into plaque psoriasis. Guttate psoriasis often appears in children or young adults and is often triggered by strep throat, skin injury, stress or certain medications.
Inverse
Also known as flexural psoriasis, this type of psoriasis usually appears in skinfolds such as the armpits, under the breasts or in the groin area. The affected skin is red, smooth and shiny. It generally does not shed any scales because of the sweat and moisture in the skinfolds. Most people with inverse psoriasis will have one of the other types elsewhere on their body.
Pustular
In pustular psoriasis, the patient will have white, pus-filled pustules surrounded by red skin. Pustular psoriasis can occur in isolated areas or all over the body. Some patients experience periods of active psoriasis followed by periods of remission. There are three kinds of pustular psoriasis: acropustulosis, palmoplantar pustulosis (PPP), and von Zumbusch.
Von Zumbusch is the most dangerous form of pustular psoriasis and can be life threatening. In von Zumbusch, parts of the skin suddenly turn red, and the reddened areas become tender and painful. Pustules appear a few hours later and dry out within 24 to 48 hours, leaving the skin looking smooth and glazed. Other symptoms include dehydration, chills, fever, severe itching, weakness, severe fatigue, weight loss, weakness and a rapid pulse.
Palmoplantar pustulosis (PPP) affects the hands and feet. The pustules appear on the palms, base of the thumb, sides of the heels, and soles of the feet. They start by forming a studded pattern on reddened skin, but they gradually turn brown, peel and develop a crust. PPP is usually cyclical with periods of remission between crops of pustules.
Acropustulosis is a rare form of psoriasis in which the pustules appear on the tips of the fingers and occasionally the toes. The pustules are painful to the point of disabling the patient, and they can also deform the nails. Severe cases can damage the bones. Acropustulosis is sometimes triggered by an infection or injury of the skin.
Erythrodermic
This is the rarest and most serious form of psoriasis; it can require hospitalization. The patient looks like a burn victim. Psoriasis can cover large parts of the body, and the scales that flake off tend to be bigger than those seen in other types of psoriasis. Erythrodermic is extremely painful, and it can develop from severe and poorly controlled plaque psoriasis. It can also occur with pustular psoriasis. Causes of erythrodermic psoriasis include severe sunburn, alcoholism, stress, infection or an abrupt discontinuation of a medicine for systemic psoriasis.
If you have psoriasis and are not sure what to do or have any questions about your condition, our doctors and professionally-trained staff at Doctor’s Approach will be able to assist you. Contact us to schedule a consultation today.