Types of psoriasis

The major types of psoriasis include the following.

Plaque psoriasis is the most common type. Nearly 90% of people with psoriasis have this type. Symptoms of plaque psoriasis include:¹

• Round or oval sores that range from 0.39in. to many inches (centimeters) wide, and may expand into patches.
• Sores that are red and covered with loose, silvery, scaling skin.
• Sores that are usually found on the elbows, knees, and trunk.

Guttate psoriasis is the second most common type, affecting up to 10% of people with psoriasis, primarily children and young adults.¹ It is also called raindrop psoriasis. People with guttate psoriasis may have:

• Many small sores the size of small drops of water.
• Sores that develop suddenly, usually on the trunk, arms, legs, and scalp.
• Outbreaks of sores that may occur with a cold or other upper respiratory infection. The sores also may occur after an episode of tonsillitis or strep throat.

Psoriatic arthritis occurs in 6% to 40% of people with psoriasis. Estimates vary depending on the population being studied and the method of diagnosis.^{2, 3} Symptoms of psoriatic arthritis include:

• Joint symptoms that occur before, at the same time, or after skin symptoms develop.
• Joint symptoms in the hands and feet.
• Joint and skin symptoms that are long-lasting and return often (chronic). Symptoms can range from mild to disabling. A chronic, low-level bacterial infection or a serious joint injury in people who have psoriasis may trigger arthritis. The joint symptoms usually improve after skin symptoms improve.

Seborrheic psoriasis is also called inverse psoriasis or seborrhiasis. Symptoms include sores that are:

• Large and red and very inflamed and dry. There is not a lot of scaling.
• Commonly found in the skin folds near the armpits, under the breasts and the buttocks, in the groin area, around the anus, behind the ear, and on the face.

Pustular psoriasis is another type, and its symptoms include:

• Fluid-filled (noninfectious pus) sores that appear on the palms of the hands and soles of the feet. The skin is very scaly.
• Larger affected areas of skin (plaque) or small, drop-sized sores that may also appear on other body parts.
• Nail changes.
• Flares that occur after you stop taking certain medicines (such as oral corticosteroids) or stop using certain creams (such as high-strength corticosteroid creams).

Erythroderma, or exfoliative psoriasis, is an extremely rare form that may be disabling or fatal. People with erythroderma may have:

• Symptoms that affect the entire body, not just the skin.
• Inflammation and redness on skin all over the body. The skin may shed or slough off and is usually itchy and painful.
• Chills and inability to regulate body temperature.

Citations

1. Abel E, Lebwohl M (2005). Psoriasis. In DC Dale, DD Federman, eds., ACP Medicine, section 2, chap. 3. New York: WebMD.

2. Mease PJ (2005). Psoriatic arthritis therapy advances. Current Opinion in Rheumatology, 17(4): 426–432.

3. Lee CS, Koo J (2007). Papulosquamous disorders. In RE Rakel, ET Bope, eds., Conn's Current Therapy, pp. 931–936. Philadelphia: Elsevier Saunders.