Types of psoriasis are defined by location, severity and appearance. The most common form is plaque psoriasis (80%). A patient can develop more than one type at one time, or over time. It’s important to know the type and severity of your psoriasis when determining an effective treatment plan with your doctor.
Psoriasis Gallery
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Plaque psoriasis
The most typical form of the disease. A "plaque" is the name used to describe the well-defined patches of red, raised skin, and the word "lesion" is also commonly used. The flaky, silvery white buildup on top of the plaques is called scale; it is composed of dead skin cells. This scale comes loose and sheds constantly from the plaques. Skin affected with psoriasis is generally very dry, and other possible symptoms include skin pain, itching and cracking. Most commonly affects knees, elbows, scalp, behind the ears, umbilicus, intergluteal cleft, and genitalia.
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Guttate psoriasis
Resembles small, red, individual drops on the skin. These lesions generally appear on the trunk and limbs, and sometimes on the scalp, and they are usually not as thick or as scale-covered as plaque psoriasis. Guttate psoriasis often starts in childhood or young adulthood, and it may be triggered by an infection of some sort.
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Inverse psoriasis
Also called flexural psoriasis, is found in the armpits, groin, under the breasts and in other skin folds around the genitals and buttocks. This type of the disease appears as smooth, dry areas of skin that are red and inflamed but do not have the scaling associated with plaque psoriasis. Inverse psoriasis is particularly subject to irritation from rubbing and sweating because of its location in skin folds and tender areas. It is more common and troublesome in overweight people.
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Erythrodermic
A particularly inflammatory form of psoriasis that affects 100% or nearly 100% of the body surface area, leaving little or no normal skin left. It can be triggered by the use of certain medications (e.g., corticosteroids), by severe sunburn, or by other types of psoriasis that have not been treated appropriately. It is the least common form of the disease. It most commonly appears on people who have unstable plaque psoriasis, where lesions are not clearly defined. The erythrodermic form of psoriasis is characterized by periodic, widespread, fiery redness of the skin. The erythma (reddening) and exfoliation (shedding) of the skin are often accompanied by severe itching and pain. Swelling may also develop.
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Generalized pustular
Pustular psoriasis spread over wide areas of the body is also called von Zumbusch pustular psoriasis, named after the physician who first described it in the early 1900s. In this relatively rare form of the disease, widespread areas of reddened skin (erythema) develop, and the skin becomes acutely painful and tender. Pustules—blisters of non-infectious pus—may appear on the skin, dry, then reappear in repeated cycles lasting several days. It is very severe and difficult to treat. Average age of a patient with pustular psoriasis is 50 but the range is wide.
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Localized pustular
Pustules of psoriasis can be confined to local areas, particularly the hands and feet. The pustules appear in a studded pattern throughout reddened plaques of skin, then turn brown and peel. Average age of onset is 50 and occurs more frequently in women. It is also very difficult to treat and recurs often.
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Scalp psoriasis
Characterized by plaque-type lesions. Half of people with psoriasis have it on their scalps.
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Nail psoriasis
Appears as large deep, random pits on the nails. Fingernails are more commonly affected than toenails. May also closely resemble fungal infection of the nail (onychomycosis) which must be tested for. Up to 80% prevalence in psoriatic arthritis patients.
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Psoriatic arthritis
An inflammatory arthritis associated with psoriasis. The condition may resemble and can be confused for rheumatoid arthritis (RA), however, patients with psoriatic arthritis usually have negative blood tests for RA (<10% may be positive versus 80% for RA).
