Sunday, 13 July 2014

Type of Psoriasis

Psoriasis is a chronic inflammatory skin disease. Psoriasis is a non-contagious disease. Characteristic look of psoriasis is red patches on skin that is accompanied by silvery-white scales of dead skin cells. Psoriasis vary in appearance, it often appears as small, flat, scaly bump or large thick plaque of raised skin.

There are different types of psoriasis:

plaque psoriasis
Plaque psoriasis is the most common type of psoriasis. Plaque psoriasis presents itself as raised, inflamed, red skin covered by silvery white scales. Patient may experience itching or burning sensation. Plaque psoriasis can appear in any part of body but it commonly appears on elbow, knees, scalp or lower back.
Certain gene mutations and environmental factors play a role in the development of the disease. Once the mutated genes are inherited some kind of environmental factor is necessary for the development of plaque psoriasis.

Plaque psoriasis affects the finger and toe nails that resemble fungal infection. Appearance of individual lesion and its distribution helps in confirming the diagnosis.
Avoid picking and rubbing off the scales.
Types of chronic plaque psoriasis:
  • Large plaque psoriasis: plaques are red, thick, well demarcated with silver scales. Its onset is early before the age of 40 years.
  • Small plaque psoriasis: characteristic appearance of small plaque psoriasis is presence of various lesions of few millimetres to few centimetres in diameter.

Word Guttate is derived from Latin word gutta; that means drop. Guttate psoriasis presents itself as small pink drops on skin. These drop like lesions are covered with fine scales. Eruptions start appearing on trunk, arms or legs and may spread to ears, face or scalp. Bottom of feet and palms are usually not affected. scratching and vigorous rubbing should be avoided.

Guttate psoriasis is triggered by streptococcal bacterial infection. Skin lesions appear usually within two to three weeks of strep throat. Other than streptococcal bacterial infection, chicken pox or colds can also trigger guttate psoriasis.

Guttate psoriasis is common in children and adults below 30 years of age. Both genders are equally affected. Triggering factors of guttate psoriasis include the following:

• Streptococcal infection in the form of tonsillo-pharyngitis. Exact mechanism by which this infection triggers the guttate lesions is not known.
• Viral infection such as rubella, chickenpox and roseola.

Diagnosis of Guttate psoriasis is done by looking at the characteristic appearance of the skin. Blood test may confirm the recent history of streptococcal infection. In more than half of the patients there is increased level of antibodies to streptolysin-O are present.

inverse psoriasis

Inverse psoriasis looks like bright-red smooth shiny lesions. Inverse psoriasis commonly appears in folds of skin like armpits, groin, under the breast, abdominal folds or skin folds around genitals or buttocks. As inverse psoriasis is present in skin folds it may worsen from sweating and rubbing.
Fungal infection triggers the lesions of psoriasis.


pustular psoriasis
Pustular psoriasis, as the name indicates, it appears as pus filled bumps surrounded by red skin. Redness of skin appears first and then formation of scales followed by formation of pus filled bumps. When pustular psoriasis covers most of the body it is called generalized pustular psoriasis which needs immediate medical attention. Generalized pustular psoriasis causes fever, chill, nausea, weakness in muscle and fast heart rate.
Pustular psoriasis is triggered by steroids, exposure to certain chemicals, overexposure to sun rays, sudden withdrawal of strong topical steroids, pregnancy, infection or stress.

Causes of pustular psoriasis: taking systemic steroids or medications, infections, pregnancy or hypoglycemia.

Depending on the symptoms lesions may be acute, subacute and chronic. This is an uncommon form of psoriasis. Tongue may get affected which makes it difficult to swallow. If nails are affected it comes off the nail bed. In a day the pustules fuse together to make large area of pus that becomes dry and peel off in sheets. Underneath skin is smooth and reddish. This phase occurs for days to weeks. Pustular psoriasis of palms and soles are chronic that may be associated with bone or joint inflammation.

Other symptoms disappears with the improvement of pustules. In few people the skin remains right red and symptoms of psoriasis may continue.

Factors that have triggering effects on psoriasis should be avoided such as smoking, exposure to sun, stress, alcohol.
Pustular psoriasis have some complications such as nail loss, hair loss, bacterial skin infections, hypocalcemia, liver and kidney damage.


nail psoriasis
Appearance of fungal infection is common in patient with nail psoriasis. Keep the nails dry and protect the nail from damage.
The cause of development of nail psoriasis is exactly known.
Characteristic appearance of nail psoriasis is:
• Color of nail changes from yellowish-red that resembles drop of blood or oil under the nail.
• Development of pits in the nail due to loss of cell from surface of nail.
• Development of Beau lines of nail, i.e. side to side line across to nail.
• Presence of areas of white on nail plate. This is known as leukonychia or midmatrix disease.
• Nail start getting separated from skin.
• Nail starts crumbling because of unhealthy underlying structures.
• Pale arched area at the bottom of the nail becomes red.
• With nail changes arthritis of finger develops.


A large area of body is affected in erythrodermic psoriasis. A widespread area of fiery red skin appears in erythrodermic psoriasis in addition with:
• Severe itching.
• Burning or peeling.
• Change in body temperature.
• Increase in heart rate.
Erythrodermic psoriasis may trigger from sudden withdrawal of psoriasis treatment, allergic drug reaction, infection or sunburn.