Types of Psoriasis and Treatment Options

Curated by Claudia Shannon / Research Scientist / Honayst

Who Can Get Psoriasis?

Anyone can have psoriasis. More than 8 million Americans are affected, and it occurs equally in men and women. Psoriasis can occur at any age but is most often diagnosed between the ages of 15 and 25. It is more frequent in white people.

Psoriasis is a non-curable, chronic skin condition, and there will be periods when the condition will improve, and other times it will worsen. The symptoms can range from mild, small, faint dry skin patches where a person may not suspect they have a skin condition to severe psoriasis where a person's entire body may be nearly covered with thick, red, scaly skin plaques.

What Causes Psoriasis?

The cause of psoriasis is unknown, but several risk factors have been identified. There seems to be a genetic predisposition to inheriting the illness, as psoriasis is often found in family members. Environmental factors may play a part in conjunction with the immune system. What causes certain people to develop an outbreak of psoriasis? The triggers vary from person to person, and may include:

  • Stress
  • Illness
  • Weather
  • Skin Injury

What Does Psoriasis Look Like?

Psoriasis usually appears as red or pink plaques of raised, thick, scaly skin. However, it can also appear as small, flat bumps or large, thick plaques. It most commonly affects the skin on the elbows, knees, and scalp, though it can appear anywhere on the body. The following slides will review some of the different types of psoriasis.

Plaque Psoriasis

The most common form of psoriasis that affects about 80% of all sufferers is psoriasis vulgaris ("vulgaris" means common). It is also referred to as plaque psoriasis because of the well-defined areas of raised red skin that characterize this form. These raised red plaques have a flaky, silver-white buildup on top called scale, made up of dead skin cells. The scale loosens and sheds frequently.

Guttate Psoriasis

Psoriasis that causes small, salmon-pink colored drops on the skin is guttate psoriasis, which affects about 10% of people with psoriasis. There is usually a fine silver-white buildup (scale) on the drop-like lesion that is finer than the scale in plaque psoriasis. This type of psoriasis if commonly triggered by a streptococcal (bacterial) infection. About two to three weeks following a bout of strep throat, a person's lesions may erupt. This outbreak can go away and may never recur.

Inverse Psoriasis

Inverse psoriasis (also called "intertriginous psoriasis") affects about 20% to 30% of people with psoriasis. Inverse psoriasis appears as very red lesions in body skin folds, most commonly under the breasts, in the armpits, near the genitals, under the buttocks, or in abdominal folds. Sweat and skin rubbing together irritate these inflamed areas.

Pustular Psoriasis

Pustular psoriasis consists of well-defined, white pustules on the skin. These are filled with pus that is non-infectious. The skin around the bumps is reddish, and large portions of the skin may redden as well. It can cycle from redness of the skin to pustules and scaling.

Erythrodermic Psoriasis

Erythrodermic psoriasis is a rare type of psoriasis that is extremely inflammatory and can affect most of the body's surface causing the skin to become bright red. It appears as a red, peeling rash that often itches or burns.

Psoriasis of the Scalp

Psoriasis commonly occurs on the scalp, which may cause fine, scaly skin or heavily crusted plaque areas. This plaque may flake or peel off in clumps. Scalp psoriasis may resemble seborrheic dermatitis, but in that condition the scales are greasy.

Psoriatic Arthritis

Psoriatic arthritis is a type of arthritis (inflammation of the joints) accompanied by inflammation of the skin (psoriasis). Psoriatic arthritis is an autoimmune disorder in which the body's defenses attack the joints of the body, causing inflammation and pain. Psoriatic arthritis usually develops about 5 to 12 years after psoriasis begins. About 30% of people with psoriasis will develop psoriatic arthritis.

Can Psoriasis Affect Only My Nails?

In some cases, psoriasis may involve only the fingernails and toenails, although more commonly, nail symptoms will accompany psoriasis and arthritis symptoms. The appearance of the nails may be altered, and affected nails may have small pinpoint pits or large yellow-colored separations on the nail plate called "oil spots." Nail psoriasis can be hard to treat but may respond to medications taken for psoriasis or psoriatic arthritis. Treatments include topical steroids applied to the cuticle, steroid injections at the cuticle, or oral medications.

Is Psoriasis Curable?

Right now, there is no cure for psoriasis. The disease can go into remission periods when there are no symptoms or signs present. Current research is underway to find better treatments and a possible cure.