Psoriasis rashes can occur in several different forms. All types of psoriasis rashes are caused when the infection-fighting white blood cells, called T-cells, malfunction. Under normal circumstances, T-cells fight against foreign invaders. However, in individuals with psoriasis, the T-cells actually attack the skin. The rash of psoriasis results from a combination of damage to the skin by T-cells, inflammation in the skin, and overproduction of new skin cells. To effectively treat your psoriasis rash, you must first identify the type of psoriasis rash you have.
Plaque-type psoriasis is the most common form of psoriasis rash. Inflamed skin lesions topped with silvery white scales are characteristic of a plaque-psoriasis rash. The scales are actually a buildup of dead skin cells.
Chronic (or common) plaque psoriasis affects over 90% of sufferers. It usually appears on the scalp, lower back, elbows, arms, legs, knees and shoulders. The chronic plaque-type is very much an adult condition and is seldom seen in children. Chronic plaque psoriasis rashes are not always itchy, nor is it always an uncomfortable condition, but its appearance, along with the shedding of the skin, can cause many sufferers a great deal of emotional discomfort.
Guttate psoriasis is characterized by small red dot-like lesions. The word guttate is derived from the Latin word gutta meaning "drop." It may be described as looking like a drop of psoriasis. Guttate is the most common type of psoriasis occurring in children and young adults who have a prior history of upper respiratory infection, pharyngitis, or tonsillitis (Camisa 64). The lesions are not as scaly as plaque-type psoriasis and are likely to be found on the trunk and involve the face. The facial lesions of a guttate psoriasis rash are sometimes confused with the papules of rosacea.
Guttate psoriasis is also known as Eruptive psoriasis and is considered the least severe form of psoriasis rash.
Pustular psoriasis is characterized by pustules, which are blister-like lesions of non-infectious fluid, and cause intense scaling. This type of psoriasis rash usually appears as a large red area covered with yellow-green pustules.
Pustular psoriasis rashes can be classified depending on the severity of the symptoms:
1) Acute in which the symptoms appear suddenly and are severe in appearance.
2) Chronic, which are, classified as long-term episodes, which re-occur frequently.
3) Sub-acute which a classification in-between sudden and severe episodes and long-term re-occurring episodes.
Pustular psoriasis is further divided in subsets defining specific symptoms and conditions in which it occurs:
Erythrodermic psoriasis is the least common form of psoriasis rash in which the rash is spread over large sections of the body and is characterized by intense redness and swelling, exfoliation of dead skin, and pain. It most commonly appears on people who have unstable plaque psoriasis, where lesions are not clearly defined. Individuals with this type of psoriasis may experience chills, low grade fever, and may be rather uncomfortable. This is also a more serious form of the condition and one that needs expert medical management.
Inverse or Flexural psoriasis is characterized by smooth inflamed lesions in the body folds -- the rash appears under the armpits, under the breast, skin folds of the groin, buttocks, and genitals. Inverse psoriasis is particularly subject to irritation due to rubbing and sweating. Flexural psoriasis rarely occurs by itself. It is more likely to accompany common plaque psoriasis. Psoriasis sufferers in their middle years or old age are more susceptible to this type of psoriasis as are people who are overweight and have more folds of skin.
Koebner's Phenomenon psoriasis are psoriatic lesions which appear at the site of injury, infection or other skin psoriasis, or may be a new lesion in an existing rash. The cause of the Koebner's phenomenon is unknown, however, it is more prevalent in patients who develop psoriasis before age 15. Up to 50% of psoriasis patients will experience new lesions forming at the site of healing wounds. Approximately 10% of psoriasis sufferers experience the Koebner's Phenomenon with every skin injury or condition, and its chances of occurring increase when the psoriasis is in an active stage.
Psoriasis and arthritis can occur together. Approximately 10% of patients who have psoriasis also develop an associated inflammation of their joints. When this happens, it is known as psoriatic arthritis. Psoriatic arthritis usually occurs in the joints of the fingers and toes. Patients with psoriatic arthritis often report the occurrence of acne as well as changes in their nails.
Seborrheic scalp psoriasis usually consists of red, scaly patches that may appear lumpy. The edges of these patches tend to be well defined. Seborrheic scalp psoriasis can extend beyond the hairline, onto the forehead. The scalp may be the first site on the body to be affected by psoriasis.
Seborrheic scalp psoriasis may resemble severe dandruff. Patches of thick, flaky skin may extend to the forehead below the hairline. Scales may build up in the outer ear. The face itself is usually unaffected; this is an important feature in the diagnosis of scalp psoriasis due to the fact that with rosacea you can have episodes of seborrheic dermatitis.
Ear Psoriasis can appear as dry scales in the ear canal. Psoriasis in the ears can cause scale buildup that blocks the ear canal. This scaling, when combined with normal earwax, can sometimes produce the physical blockage of the external ear canal leading to a temporary decrease in hearing. Psoriasis of the ears occurs in approximately 18 percent of all patients at some time.
Nail Psoriasis can affect both the toenails and fingernails. Psoriatic changes in nails range from mild to severe, generally reflecting the extent of psoriatic involvement of the nail plate, nail matrix (tissue from which the nail grows), nail bed (tissue under the nail), and skin at the base of the nail.
Nail psoriasis is frequently associated with psoriatic arthritis. Certain medications may make psoriasis worse. These include lithium (prescribed to treat bipolar disorder, beta blockers (prescribed for heart problems), anti-malarial drugs, and nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen are available by prescription or over the counter for pain relief. NSAIDs are often used to treat psoriatic arthritis. In such cases, the benefits and risks of treatment need to be carefully assessed. Flare-ups of psoriasis caused by NSAIDs usually respond to treatment.
Ocular psoriasis can cause inflammation of the eye, dryness and discomfort. When psoriasis affects the eyelids, scales may cover lashes. The edges of the eyelids may become red and crusty. If inflamed for long periods, the rims of the lids may turn up or down. If the rim turns down, lashes can rub against the eyeball and cause irritation.
Blepharitis is the most prevalent ocular occurrence in psoriasis. Erythema, edema, and psoriatic plaques may develop. It usually causes burning, itching, and irritation of the lids. Other common symptoms include sandy, itchy eyes, red and/or swollen eyelids, crusty, flaky skin on the eyelids, and dandruff. The key to controlling blepharitis is to keep the eyelids and eye lashes clean.
Uveitis and iritis frequently arise as a complication of psoriatic arthritis or lupus, in which the body's immune system attacks its own healthy tissue. Uveitis is an inflammation of the uvea, the middle layer of the eye's surface. The uvea includes the iris, the colored area at the front of the eye. Symptoms of uveitis can include: redness in the eye, sensitivity to light, blurred vision, pain in the eye or "floaters" in the field-of-vision. When uveitis is localized at the front of the eye, it's called iritis. Iritis is an inflammation of the iris, a part of the eye. Symptoms include eye pain, sensitivity to light, and/or blurry vision and are often confused with the symptoms of conjunctivitis.
The symptoms of a psoriasis rash can encompass different stages. Some people may experience limited psoriasis symptoms while others may experience more widespread symptoms of psoriasis. Psoriasis occurs when skin cells mature at an accelerated rate. On a normal basis, skin cells grow, mature, and shed about once a month. Skin cells of a person with psoriasis grow nearly seven times faster and build up at the skin's surface resulting in red, raised, scaly patches and lesions. Although some individuals complain of itching, it is not a very common complaint. Only 30% of people with psoriasis complain of itching. Individuals who scratch their psoriasis can cause cracking and bleeding, making the symptoms of their condition worse. Development of psoriasis is caused by genetic factors and approximately one-third of individuals with this condition can trace the cause to a positive family history. Without treatment, psoriasis is a potentially life-disruptive condition. Research has shown that many people seeking treatment have even missed work because of their condition.
Eczema is a variety of skin conditions most often confused with psoriasis. The symptoms of eczema include but may not be limited to: itching, cracking, stinging, burning, or bleeding. In the early stages of eczema the skin may turn red, blister, and ooze. Later stages of eczema can cause the skin to turn a brownish color and be scaly. In almost every case, eczema itches.
