Psoriasis Types, Causes, and Symptoms: A Complete Overview

Overview

Have you ever seen little, gray, scaly plaques that seem to linger on the surface of your skin? There is a condition of psoriasis that you could be suffering from. You’re not alone – Millions of people around the globe are experiencing the same challenge. Psoriasis is, in fact, much more than just a skin disease – it is an autoimmune disease that impacts millions of people.

If you or a loved one has recently been diagnosed with psoriasis then you must be having numerous questions in your mind. No need to fret though, we have listed down some of the ways that you can use as a guide to help you out. This guide will also cover all parameters related to psoriasis such as types of psoriasis, the possible causes of psoriasis, and its treatment.

This is important since there are different types of psoriasis and this will require one to know more about them so that to handle them accordingly. Thus, the more you know about these various forms, the easier it will be to identify the signs and go for the right management or treatment.

In this article we will discuss in detail what psoriasis is, what are the types, symptoms, causes and ways to treat it. The purpose of this guide is to offer useful information and tips to people who have just been diagnosed with psoriasis or want to learn more about it.

Meet The Psoriasis Family: Psoriasis Types

Type 1: Plaque Psoriasis

Plaque psoriasis is arguably considered the most representative form of psoriasis types as it is evident in 80 to 90% of sufferers. If you have ever watched those adverts depicting individuals with rashes on their skin, which resemble red and scaly –those are symptoms of plaque psoriasis^[1].

What are its features? Picture this: The skin changes its color and rises, red patches of skin are covered with silvery-white scales. These patches, known as plaques, can appear at any location but have a special predilection for elbows, knees, scalp, and the lower back. It is as if the skin thought it was time to build its own shelters, and not very pleasant ones at that, from a comfort point of view.

Watch for the Symptoms:

• Itching: And it’s no soft tickle. It may be an irresistible and severe itch.
• Burning sensation: Some describe it as a constant, low-grade burn.
• Cracking and bleeding: When the plaques become too dry or are scratched, they may crack and bleed.
• Thick, pitted nails: Your fingernails and toenails might join in on the fun by becoming thick, ridged, or pitted.

What Triggers It?

The causes of plaque psoriasis are many

• Stress: Bad week at the office? Your skin could act out because of it.
• Trauma to the skin: Even something as insignificant as a cut or an abrasion may be used as a callus for plaque to appear on that site, known as the Koebner phenomenon.
• Infections: Battling a cold? Your immune system can overreact and create a flare-up.
• Certain medications: Some medicines, in particular lithium and beta-blockers, can make psoriasis worse.

Plaque Psoriasis

Type 2: Guttate Psoriasis

Guttate psoriasis is basically the rebel teenager of the psoriasis family, it appears without giving any prior information, and if it does appear, it makes its presence felt gallantly. The term is derived from the Latin word meaning a drop because of that classic lesion appearance.

What’s its deal? Try to imagine hundreds of small, teardrop-shaped bright-red spots coming out on your skin all at once. Spots are normally more minor than those seen in plaque psoriasis spots and do not involve crusty layers on the skin’s surface. These can be elsewhere on the trunk, arms, legs and even scalp.

Watch for the Symptoms:

• Very sudden start: While plaque psoriasis can take months to form, guttate psoriasis can start seemingly overnight.
• All over the place: The spots can spread over much of the body.
• Less scaly: Whereas there is a degree of scaling, it is usually much finer than in plaque psoriasis.

What Triggers It?

Guttate psoriasis often represents the body’s over-the-top reaction to:

• Strep throat: This is major. Many cases of guttate psoriasis, particularly in kids and young adults, crop up in the wake of a streptococcal throat infection.
• Other infections: While strep is the most common culprit, other bacterial or viral infections can also lead to an outbreak.
• Stress: Like its plaque cousin, guttate psoriasis does not like stress.
• Skin injury: Cuts, scrapes, or even sunburn can sometimes lead to an outbreak.
• Certain medications: Beta-blockers and antimalarial drugs have been responsible for triggering guttate psoriasis in some people.

Guttate psoriasis is very often temporary. For many who are having their first outbreak-the condition will literally clear up on its own in weeks or months. In some people, however, it may be more resistant or even evolve into chronic plaque psoriasis^[2].

Type 3: Inverse Psoriasis

Inverse psoriasis is the smooth operator of the psoriasis world. Unlike its scaly cousins, this type keeps things sleek and shiny-but not in a good way. Inverse psoriasis can be tough to identify because it’s often mistaken for other conditions. The look and location can easily mislead doctors to misdiagnose a fungal or yeast infection. Inverse psoriasis areas are ideal spots for yeast infections to grow^[3].

Watch for the symptoms

• Inverse psoriasis is all about location. It sets up shop in the body’s skin folds, such as under the breasts, In the armpits, In the groin area, Between the buttocks, and in any other folds you may have.
• While anyone with psoriasis can develop the inverse type, it’s more common in overweight or obese individuals. The more folds of skin, the more places inverse psoriasis can erupt.
• Those with thick skin folds: you don’t have to be overweight to develop this type if you naturally have thick folds in your skin.
• It looks smooth and shiny: Unlike the more common scaly patches, inverse psoriasis consists of smooth, red, inflamed areas of skin.

What Triggers It?

The affected skin folds create a moist and warm environment. Additionally, these skin folds are extra sensitive, making them more tender and easily irritated.

Don’t be surprised, by the way; inverse psoriasis can be present along with other types of psoriasis. You may be facing multiple varieties all at once.

Type 4: Pustular Psoriasis

Pustular psoriasis is the drama queen of the psoriasis family. It’s fairly rare, but when it does crop up, it makes sure that everyone in town knows about it.

Types of pustular psoriasis^[4]:

• PP is the specific form that affects the inner side of the palms and soles.
• Acropustulosis- This is pustular psoriasis affecting the fingertips and toenails.
• Von Zumbusch pustular psoriasis: It is the most severe form of the disease and covers wide areas of the body.

Watch for the Symptoms:

• Pustules: These may be white or yellow in coloration and filled with non-infectious pus.
• Redness: The skin around the pustules is usually red and tender.
• Scaling: After the pustules have dried, scaling of the skin may be left behind.
• Systemic symptoms: You may experience these systemic symptoms, especially with Von Zumbusch type and usually with more severe cases:
• Fever Chills: Severe pruritus Dehydration Tachycardia Muscle weakness Nausea

What Triggers It Off?

• Pustular psoriasis is more commonly known to be triggered off by the following:
• Abrupt withdrawal from certain medications, such as corticosteroids Infections
• Pregnancy, though this one can be a rare form of impetigo herpetiformis
• Medication
• Overexposure to UV light Stress

Why It’s Serious: The potential for the seriousness of pustular psoriasis lies in its Von Zumbusch type. There have been several cases attributed to this condition, which have resulted in serious protein and fluid loss, skin infections, and even death. You should immediately consult a doctor if you think that you are suffering from pustular psoriasis^[5].

Pustular Psoriasis

Type 5: Erythrodermic Psoriasis

Erythrodermic psoriasis is the rarest kind of psoriasis but can be regarded as the most extreme. In a way, think of it as a five-alarm fire: it doesn’t happen often, but if it does, it needs attention right away. Erythrodermic psoriasis rarely occurs but is more likely to strike those people who have unstable plaque psoriasis. Sometimes it starts slowly, but it also can develop in a very short period^[6].

What does it look like? Picture your whole body great part of it, at least on fire with a bright red rash. It’s more than a bad sunburn, as erythrodermic psoriasis can involve up to 90% of the surface of your body. Often, the skin appears to be burned and sometimes peels in great sheets^[7].

Watch for the Symptoms:

• Generalized redness: The involved skin is bright red and appears inflamed.
• Intense scaling: Skin peels off in large sheets, rather than small scales.
• Severe itching and pain: The discomfort can be intense and unrelenting.
• Heat regulation issues: The skin loses its ability to regulate temperature effectively.

What Triggers It?

Some of the possible triggers which may result in erythrodermic psoriasis include:

• Abrupt withdrawal of systemic psoriasis treatments, especially corticosteroids
• Severe sunburn
• Infections
• Certain medications
• Uncontrolled plaque psoriasis

Why it’s dangerous: Erythrodermic psoriasis is more than just uncomfortable; it can be life-threatening. It involves severe fluid loss and dehydration due to extensive skin involvement, disrupting temperature regulation and causing chills or inconsistent body temperature. The condition often leads to tachycardia as the heart rate increases to manage stress alongside generalized inflammation. Additionally, the compromised skin barrier makes individuals susceptible to life-threatening infections.

Keep in mind that if you think you may have erythrodermic psoriasis, you should see a doctor right away. This isn’t a “wait and see” kind of thing. You need to get prompt treatment, as serious complications can arise if this form of psoriasis is left untreated.

Causes and Risk Factors

Psoriasis is a very complex puzzle, and scientists are just piecing together all of the factors that contribute to its development. While we don’t know it all, we do know that it’s a result of the perfect storm of genetic, immune system, and environmental factors combined.

Genetic Predisposition

The reason your genes seem to have a major say is whether you will develop psoriasis. Your genes set the stage for the condition^[8].

• Family history: If your immediate family members have the problem, you are at a higher risk. Thus, about one-third of people with psoriasis have a family member suffering from the condition.
• Specific genes: Scientists have identified several genes that are associated with psoriasis. This is related to genes run by the immune system and the life cycle of skin cells.
• Complex inheritance means that, whereas some genetic disorders result from a single gene, in the case of psoriasis, several genes interact in a complex manner.
• Immune System Dysfunction: In psoriasis, your immune system in effect gets its wires crossed:
• Renegade T-cells: Ordinarily, these immune cells help protect you against infection. In psoriasis, they go into overdrive.
• Inflammation overdrive: Those overactive T-cells trigger a cascade that results in even more immune cells being produced. This leads to inflammation in the skin.
• Accelerated skin cell growth: This inflammation causes skin cells to grow at a much faster rate than normal, leading to the characteristic psoriatic plaques.

Environmental Factors

Your environment and lifestyle can considerably contribute^[9] to the onset of the triggering or exacerbation of psoriasis:

• Stress: Physical and emotional stress can act as a triggering factor for flare-ups or aggravate symptoms in people with psoriasis.
• Infections: Infections, particularly strep throat, can trigger the onset of psoriasis or a flare-up.
• Medications: Lithium, beta-blockers, and antimalarial drugs are among the medications that can cause outbreaks of psoriasis in susceptible individuals.
• Skin injuries: Psoriasis can develop at the site of skin injuries, such as cuts, scrapes, bug bites, and severe sunburns. This is called the Koebner phenomenon.
• Climate: For many people with psoriasis, cold, dry climate worsens symptoms.

Other Possible Triggers

Following are some lifestyle factors^[10] that some studies have reported can worsen psoriasis or increase the risk of getting the disease:

• Smoking – Smoking not only increases the risk for acquiring psoriasis but also its severity.
• Intake of alcohol – Severe intake of alcohol can trigger flare-ups and interfere with treatment of psoriasis.
• Obesity – It can increase one’s risk for this disease and perhaps make treatment less effective.
• Vitamin D deficiency – Though still under research,^[11] low levels of vitamin D are observed to be associated with psoriasis.

Keep in mind that having one or more risk factors does not necessarily mean you will develop psoriasis, and many people with no known risk factors do develop psoriasis. It is not fully understood yet how genes, immune system functioning, and environmental factors interact with one another.

Symptoms

Living with psoriasis can feel like your skin has launched a mutiny against you. Of course, symptoms will vary depending on the type of psoriasis, and also on the individual. We have already discussed the symptoms on the skin, but here are other few common signs to look out for:

Nail Changes

Nail changes are also indicative of psoriasis^[12]:

• Pitting: Tiny depressions, as if a needle had been poked in repetitively, may develop in the surface of the nail.
• Discoloration: Often, the nails tend to take on a yellow-brown color.
• Separation: In severe cases, the nail can even detach itself from the nail bed – known as onycholysis. Thickening: The nails can grow disproportionately thick.
• Crumbling: In extreme cases, the nail may even crumble or fall off.

Joint Pain (Psoriatic Arthritis)

For many, psoriasis is deeper than the skin’s thick. It’s estimated that up to 30% of people with psoriasis develop a kind of arthritis called psoriatic arthritis. Symptoms include pain and swelling in and around the joints^[13].

• Reduced range of motion: As the problem gets worse, affected joints can become less flexible.
• Nail changes: For most people with psoriatic arthritis, the symptoms of nail psoriasis are more severe.
• Fatigue: Some people with psoriatic arthritis feel generally tired and run down.

Other Symptoms

Psoriasis might affect more than your skin and joints:

• Eye involvement: a few people develop inflammation of the eyes (uveitis) and/or psoriasis of the eyelids.
• Genital psoriasis: Many people have reddening of the skin and scaling on the penis. Women may have a membranous patch on the vulva. Apart from discomfort symptoms may include a burning sensation or sexual dysfunction.
• Psychological disturbance: it is distressing and frustrating to live with any obvious skin disease. Stress, low self-esteem, anxiety, and depression are common comorbidities.

Severity and Variability

Symptoms of psoriasis may be very variable, it may start off with a few small patches or with extensive areas of skin that cover much of the surface of the body.

Psoriasis often has cycles. It flares for a few weeks or months, then subsides for a time. Symptoms may temporarily worsen because of stress, cold weather, or infection. Remember, though, these symptoms are common in psoriasis, everybody’s different. If you’ve been experiencing several of these signs and symptoms, especially if they’re new or getting worse, it’s a good idea to talk with a health professional^[14].

Frequently Asked Questions (FAQs)

Q: Is Psoriasis Contagious?

A: No, psoriasis is not contagious. You cannot “catch” psoriasis from someone who has it, nor can you spread it to others through physical contact. Psoriasis is an autoimmune condition and not an infectious disease.

Q: Can Children Get Psoriasis?

A: Yes, children can develop psoriasis. Though it most often appears between ages 15 and 35, it can start at any age, even in infancy. Guttate psoriasis is especially common in young children and teens.

Q: Does Diet Affect Psoriasis?

A: There is no ‘Psoriasis Diet,’ but for some people, certain foods seem to trigger flare-ups or foods that help control the symptoms. Suggestions include limiting alcohol, fatty foods, increasing in omega-3 fatty acids, and keeping a healthy weight. One should consult a healthcare provider before making any considerable changes to diet.

Q: Will Psoriasis Have a Consequent Effect on My Mental Health?

A: Yes, living with psoriasis can affect one’s mental health. The visibility factor of the disease and its chronic, sometimes indeterminate course has many people feeling stressed, anxious, or depressed. Many patients develop either a tendency for low self-esteem or to become reclusive among society. It is vital that such issues be made known to your healthcare professional since after all, being able to deal with their psychological component is part of the treatment. Here’s a list of some important ones;

Q: Are There Any Natural Remedies for Psoriasis?

A: While not a replacement for medical treatment, some people are relieved by more natural remedies for Psoriasis. These might include things like aloe vera, apple cider vinegar, or even Dead Sea salt baths. Supplements in the form of essential fatty acid treatments can be found in fish oil and turmeric that seem to offer promise in small studies. Always consult your doctor before trying new treatments; even the most natural treatments can interfere with medications.

Q: Can Psoriasis Go into Remission?

A: Yes, psoriasis does go into remission. In that period, the symptoms of psoriasis will either considerably improve or even fully disappear. The remissions can last from a few weeks to years and may be spontaneous or induced by treatment. Since psoriasis is a chronic condition, after a very long remission, the symptoms may just reappear.

Q: How Does Pregnancy Affect Psoriasis?

A: It is variably affected by pregnancy. Approximately 40-60% of the females improve during pregnancy, particularly in the third trimester. Some females, however, may continue onward with worsening symptoms or not change at all. It is very important to closely collaborate with your healthcare providers since not all psoriasis treatments are safe to take during pregnancy.

Q: Can Stress Really Trigger Psoriasis Flare-Ups?

A: Is stress a trigger for psoriasis flare-ups? A: Yes, it is. While stress does not cause it, it tends to worsen symptoms in people who have the disease already. Of course, this often creates a vicious circle-the very disease itself can be stressful. Stress management techniques include meditation, yoga, and counseling.

Conclusion

Psoriasis may sound like just a skin condition, but as one delves further into it, the condition is quite a complicated autoimmune disorder. Gaining knowledge about this often misconceived disease is important, not only for those diagnosed but to everyone, for it may remind one again that not all health issues are as easily visible or simple.

By being aware of the various types, symptoms, and complications of psoriasis, we help ourselves and others get the care we need on time. If you have onsets of skin changes, itching, or unexplained joint pain, do not ignore these symptoms. What may look like only a minor skin problem might be your body’s warning of something more serious.

Keep in mind that the quality of life can be much improved, and complications can be prevented by early diagnosis and treatment. Be watchful, listen to your body, and without any suspicion of either psoriasis or any persistent health change, never wait for consultation with your healthcare professional. Your skin has a story to tell sure you read the plot right.

14 Sources

We review published medical research in respected scientific journals to arrive at our conclusions about a product or health topic. This ensures the highest standard of scientific accuracy.

[1] Plaque Psoriasis : https://my.clevelandclinic.org/health/diseases/22842-plaque-psoriasis
[2] Guttate Psoriasis : https://www.ncbi.nlm.nih.gov/books/NBK482498/
[3] Inverse Psoriasis: From Diagnosis to Current Treatment Options : https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6997231/
[4] Pustular Psoriasis : https://www.ncbi.nlm.nih.gov/books/NBK537002/
[5] Generalized pustular psoriasis (von Zumbusch) : https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8799844/
[6] Erythrodermic psoriasis: pathophysiology and current treatment perspectives : https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5572467/
[7] Erythrodermic Psoriasis : https://www.sciencedirect.com/topics/medicine-and-dentistry/erythrodermic-psoriasis
[8] How is psoriasis hereditary transmitted? : https://www.papaa.org/learn-about-psoriasis-and-psoriatic-arthritis/fertility-and-pregnancy/heredity/
[9] The role of lifestyle and nutrition in psoriasis: Current status of knowledge and interventions: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9541512/
[10] Risk Factors for the Development of Psoriasis : https://www.mdpi.com/1422-0067/20/18/4347
[11] Association between Vitamin D deficiency and psoriasis: An exploratory study: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5870311/
[12] Nail psoriasis: clinical features, pathogenesis, differential diagnoses, and management : https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5774607/
[13] Psoriatic arthritis : https://www.mayoclinic.org/diseases-conditions/psoriatic-arthritis/symptoms-causes/syc-20354076
[14] Psoriasis : https://www.niams.nih.gov/health-topics/psoriasis

Carola May

Carola May Founder of Dahliana Skincare worked as a clinical Aesthetician for the past 20 years and this experience has given her incre Read Full Bio