Psoriasis , a chronic skin disease, comes in different forms, each with its own distinct characteristics and symptoms.

The most common types of psoriasis include plaque psoriasis, which appears as thick red patches covered with silvery scales, and guttata psoriasis, which appears as small red spots scattered across the skin.

Other variants include pustular psoriasis, inverse psoriasis, and erythrodermic psoriasis, each with specific manifestations and varying degrees of severity.

Understanding these various forms of psoriasis is essential for accurate diagnosis and appropriate treatment to improve the quality of life of those affected.

How to determine the type of psoriasis?

Accurate diagnosis of the type of psoriasis is based on observation of specific characteristics of skin lesions. Itching and thick plaques are common indicators.

For example, plaque psoriasis presents with plaque-like lesions on areas such as the elbows, knees, and back. Psoriasis presents as small red spots, while pustular psoriasis involves the presence of pustules filled with pus.

Careful examination of the skin, body and even nails can provide clues to differentiate between types of psoriasis, allowing a therapeutic approach tailored to each case.

The different forms of psoriasis

Each form of psoriasis is distinguished by specific characteristics, highlighting the diversity of this skin disease. Inflammation plays a central role in all forms, but the difference lies in the way it manifests itself.

From plaque psoriasis with its thick, silvery patches, to psoriasis characterized by scattered red spots, each variant presents distinct patterns of skin inflammation. Understanding this complexity allows for more precise targeting of treatments, improving the management and quality of life for those affected by this condition.

Plaque psoriasis

Plaque psoriasis, the most common form of this autoimmune disease, presents as thick, red plaques covered with silvery scales.

This skin condition is the result of an accelerated process of cell renewal, causing the accumulation of dead cells on the surface of the skin.

These plaques can appear on different parts of the body, such as the elbows, knees, and scalp. Aside from the physical aspects, plaque psoriasis can also cause itching and significant discomfort.

Although this condition is not curable, various treatments, such as topical creams, phototherapy, and oral medications, aim to reduce inflammation, slow excessive cell turnover, and relieve symptoms , thereby improving the quality of life of affected individuals.

Guttate psoriasis

Guttate psoriasis is a distinctive variant of this skin disease, characterized by the sudden appearance of small, red, drop-like spots on the skin. These lesions can appear anywhere on the body, but often tend to be concentrated on the arms, legs, and trunk.

Unlike plaque psoriasis, this form is often triggered by infections such as strep throat. Itching can be intense, and although guttate psoriasis lesions tend to clear up on their own, they may leave behind dry, scaly skin.

Treatments aim to reduce inflammation, soothe itching and speed up the healing process, through topical creams, therapeutic baths and sometimes oral medications, depending on the severity of symptoms.

Pustular psoriasis

Pustular psoriasis is a particularly severe and rare form of psoriasis, characterized by eruptions of white pustules. These small blisters filled with white blood cells are surrounded by red, irritated skin. Don't worry: although they look infectious, these pustules are not.

This manifestation of psoriasis can present in different forms, including generalized pustular psoriasis, which affects the entire body and can cause systemic symptoms such as fever or severe fatigue. Palmoplantar pustular psoriasis, on the other hand, is limited to the hands and feet. Treatment for this condition depends on the extent and severity of symptoms and may include topical medications, systemic treatments, or biotherapies.

Management of this condition requires a tailored approach, adapted to each patient, in order to minimize complications and significantly improve quality of life.

Erythrodermic psoriasis

Erythrodermic psoriasis is an extremely severe form of psoriasis, manifesting as widespread inflammation and redness covering most of the body.

This condition can cause intense peeling of the skin, accompanied by itching or pain.

In addition to skin symptoms, erythrodermic psoriasis can disrupt the body's thermal regulation and the skin's protective barrier, making the patient more susceptible to infections and other medical complications, such as dehydration and heart failure.

Treatment often requires hospitalization and includes the administration of systemic medications and intensive skin care to stabilize the patient's condition. Due to its severity and potential impact on overall health, prompt and effective medical management is crucial.

Nail psoriasis

Nail psoriasis refers to the manifestation of psoriasis affecting the fingernails and toenails. 

It is more often associated with the psoriatic arthritis. This form of the disease is characterized by various nail changes, such as thickening of the nails, the appearance of small pits, as well as changes in color, often accompanied by lifting of the nail from the nail bed.

Patients may also notice a yellowish appearance under the nail, known as onycholysis. Nail psoriasis is not just a cosmetic issue; it can also cause pain and functional difficulties, affecting daily activities.

Treatment is usually aimed at alleviating symptoms and may include topical steroids, corticosteroid injections under the nail, or systemic therapies for more severe manifestations. Managing this form of psoriasis often requires a patient and methodical approach to improve the appearance of the nails and reduce discomfort.

Inverse psoriasis

Inverse psoriasis is a less common variant of psoriasis that occurs mainly in skin folds such as the armpits, under the breasts, around the genitals, and between the buttocks.

This form is distinguished by smooth, red, and often shiny lesions, which can be extremely sensitive or painful due to their location in areas of friction or sweating. Inverse psoriasis is particularly difficult to manage due to its location and the sensitivity of the affected skin.

Aggravating factors include sweating and continuous rubbing, which requires special care to minimize irritation. Treatment usually involves the use of low-concentration topical creams of corticosteroids and calcineurins, avoiding more potent formulations that could damage the delicate skin of the affected areas.

FAQ: Types of psoriasis

What are common triggers for psoriasis?

Psoriasis triggers vary from person to person, but some common factors include stress, infections, certain medications, and climate changes. For example, studies indicate that stress can exacerbate psoriasis symptoms in up to 80 percent of people with the condition .

Skin injuries, such as cuts or scrapes, can also cause a flare-up in affected areas, a phenomenon known as a Koebner reaction. Avoiding these triggers, when identified, can help manage and reduce the frequency of psoriasis flare-ups.

Is there a permanent cure for psoriasis?

Psoriasis, a chronic skin condition, varies from case to case in terms of severity and appearance of the patches on the skin. Although there is no definitive cure, various treatments aim to alleviate symptoms and improve the patient's quality of life.

Some drugs work on immune processes to reduce the inflammatory effect, while others aim to soothe plaques and slow their formation.

The consequences of psoriasis extend beyond the physical, often impacting self-confidence and emotional well-being. Controlled sun exposure and vitamin D supplementation can also have positive effects, but it is important that patients work closely with healthcare professionals to develop a management plan tailored to their individual needs.