Psoriasis Symptoms and Complications

Psoriasis is a chronic disease that lasts a lifetime, and the signs and symptoms of psoriasis vary depending on the person and type of psoriasis.

For some people, psoriasis symptoms can clear up for months or years at a time. This is known as remission. (1)

Common symptoms of psoriasis include:

  • Red patches of skin covered with silvery scales (called plaques)
  • Small, round, scaly spots (commonly seen in children)
  • Dry, cracked skin that may bleed
  • Itching, burning, or soreness
  • Thickened, pitted, or ridged nails
  • Swollen and stiff joints

Psoriasis patches can range from a few spots of dandruff-like scaling to major eruptions that cover large areas.

Most types of psoriasis go through cycles, flaring for a few weeks or months, then subsiding for a time or even going into complete remission.

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What Are the Signs and Symptoms of Plaque Psoriasis?

Plaque psoriasis is the most common type. As many as 90 percent of people with psoriasis have this form, according to the American Academy of Dermatology. (2)

If you have plaque psoriasis, one of the most common symptoms is raised, red patches of skin that are covered with a silvery scale. These patches are known as plaques. The following are signs that you may have plaque psoriasis:

  • Raised, reddish patches that can appear anywhere on the skin
  • Silvery-white coating on patches
  • Common locations for patches include the knees, elbows, lower back, and scalp
  • Itching
  • Patches that thicken when scratched
  • Patches varying in size, and either alone or joined together
  • Nails with pits that are crumbling or fall off

What Are the Signs and Symptoms of Guttate Psoriasis?

Guttate psoriasis is the second most common type of psoriasis, affecting roughly 10 percent of people who have the disease, according to the National Psoriasis Foundation (NPF). (3)

This type of psoriasis may clear up without any treatment, but it sometimes requires medical attention. It may appear for a single episode, typically following an illness like strep throat, or it may signal the start of plaque psoriasis.

The typical symptoms of guttate psoriasis include:

  • Small, red spots that are most common on the trunk, arms, and legs, but can show up anywhere on your body
  • Spots that clear up in a few weeks or months without treatment

What Are the Signs and Symptoms of Pustular Psoriasis?

Pustular psoriasis is an uncommon form of the disease that usually affects adults. (4) Possible symptoms may include:

  • Red, swollen, and dotted skin with pus-filled bumps
  • Bumps, often only on the palms and soles
  • Soreness and pain on the bumps
  • Brown dots or scale on the skin after pus-filled bumps dry

When pus-filled bumps cover the body, you may have bright-red skin and feel ill, exhausted, have a fever, chills, severe itching, rapid pulse, loss of appetite, or muscle weakness.

What Are the Signs and Symptoms of Inverse Psoriasis?

Inverse psoriasis, also known as flexural psoriasis, is a type of psoriasis that forms in the body's skin folds, such as the armpits, genitals, and under the breasts. (5) It is the inverse of the more common plaque psoriasis, which occurs on the outer, extensor surfaces of the body, such as the knees and elbows.

Inverse psoriasis occurs in 2 to 6 percent of people with psoriasis, usually alongside some other form of the condition. It can be one of the most painful and irritating forms of the disease.

The symptoms of inverse psoriasis include:

  • Smooth, red patches of skin
  • Sore skin
  • Patches only on creases of the skin, like the armpits, near the groin, genitals, and buttocks
  • Raw patches under a woman's breast

What Are the Signs and Symptoms of Erythrodermic Psoriasis?

Erythrodermic psoriasis is a rare type of psoriasis, diagnosed in roughly 3 percent of people with the disease. (6) It is a particularly inflammatory form of psoriasis that affects most of the body, and it can occur in association with pustular psoriasis. Its symptoms include:

  • Skin that looks burned
  • Most of skin turns bright red
  • Feeling very hot or very cold
  • Rapid heartbeat
  • Intense itching
  • Severe pain

How Is Psoriasis Diagnosed?

Most of the time, your physician can diagnose psoriasis by taking your medical history and examining your skin, scalp, and nails.

In some cases, a skin biopsy may be done to determine the type of psoriasis, and to rule out other disorders that look similar to psoriasis, such as dyshidrotic eczema, seborrheic dermatitis, lichen planus, ringworm, and pityriasis rosea.

Can Psoriasis Lead to Other Health Complications?

Having psoriasis could put you at risk for developing other medical conditions. (7)

Your skin plays a vital role in regulating body temperature, providing hydration, and protecting against infection.

When skin disorders such as psoriasis affect the body, certain changes take place that may lead to additional problems.

Doctors aren’t sure if the risk of developing other conditions is solely related to the disease itself or if psoriasis treatment also plays a role.

According to the NPF, about 10 to 30 percent of people with psoriasis will develop psoriatic arthritis, which is a form of psoriasis that affects the joints. (8)

People with psoriatic arthritis suffer from painful, swollen joints and other symptoms.

You can develop psoriatic arthritis any time, but it most commonly appears between age 30 and 50.

Psoriasis and psoriatic arthritis can increase your risk of developing the following health problems:

Cardiovascular Disease You’re more likely to have this condition if you have severe forms of psoriasis or psoriatic arthritis. In fact, individuals with severe psoriasis are 58 percent more likely to have a major cardiac event and 43 percent more likely to have a stroke, according to the NPF. (10) Some research shows that treating psoriasis may help lower your risk of heart attack and stroke.

Eye Diseases Certain eye conditions are more common in people with psoriasis and psoriatic arthritis. These may include conjunctivitis (commonly known as pink eye), uveitis (an inflammatory disease of the eye), and blepharitis (inflammation of the eyelid). An estimated 7 percent of people with psoriatic arthritis will develop uveitis. (15)

High Blood Pressure Psoriasis and psoriatic arthritis could increase your risk of having high blood pressure. If blood pressure is uncontrolled, it can lead to coronary artery disease, heart failure, stroke, or kidney failure.

Liver Problems People with psoriasis and psoriatic arthritis may have an increased risk for developing nonalcoholic fatty liver disease, a condition where too much fat is stored in liver cells. (10)

Obesity Experts aren’t sure exactly why, but obesity is strongly associated with psoriasis and psoriatic arthritis. Some research suggests that it’s the psoriasis that could lead to obesity, while other studies have shown people who are obese are more likely to develop certain forms of psoriasis. (10) Losing weight may help improve psoriasis symptoms.

Additional reporting by George Vernadakis

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