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Types of psoriasis

Dermatologists distinguish different forms of psoriasis according to what part of the body is affected, how severe symptoms are, how long they last, and the pattern formed by the scales.

Plaque psoriasis also known as Psoriasis vulgaris, is the most common form of the disease. About 80% of people who develop psoriasis have plaque psoriasis. It is characterized by raised, red patches or lesions covered with a silvery white build-up of dead skin cells, called scale. Plaque psoriasis can develop on any area of the skin, but most often occurs on the elbows, knees, scalp, and trunk.

Guttate psoriasis. (named for the Latin gutta, "a drop") often starts in childhood or young adulthood and is characterized by small, red, drop-like dots rapidly expanding and sometimes scaly. Often found on the arms, legs, and trunk and sometimes in the scalp, guttate psoriasis can clear up without treatment or disappear and resurface later in the form of plaque psoriasis.

Pustular psoriasis mostly occurs in adults. It is characterized by blister-like lesions filled with non-infectious pus and surrounded by reddened skin. It is not an infection, nor is it contagious. Pustular psoriasis may be limited to some parts of the body, like hands and feet. This relatively unusual form of psoriasis affects fewer than 5% of all people with psoriasis. It tends to go in a cycle: reddening of the skin followed by formation of pustules and scaling.

  • Generalized pustular psoriasis also known as Von Zumbusch pustular psoriasis are characterized by widespread, acutely painful patches of inflamed skin. Pustules appear within a few hours, then dry and peel within two days. Generalized pustular psoriasis can make life-threatening demands on the heart and kidneys.
  • Palomar-plantar pustulosis (PPP) generally appears between the ages of 20 and 60. It causes large pustules to form on the palms of the hands and/or the soles of the feet. Characterized by a mass of weeping, cracked areas which look like tiny, yellowish blisters. These can be very painful and sore. In time, the pustules turn brown and peel. The disease becomes much less active for a while after peeling.
  • Acrodermatitis continua of Hallopeau is a form of PPP characterized by painful, often disabling, lesions on the fingertips or the tips of the toes. The nails may become deformed, and the disease can damage bone in the affected area.

Inverse psoriasis occurs in the armpits and groin, under the breasts, and in other areas where skin flexes or folds. It first shows up as lesions that are very red and usually lack the scale associated with plaque psoriasis. It may appear smooth and shiny. Inverse psoriasis specifically associated with irritation from rubbing and sweating because of its location in skin folds and tender areas. It is more common and troublesome in overweight people and people with deep skin folds.

Erythrodermic psoriasis. Distinguished by a severe scaling, itching, and pain that affects most of the body, erythrodermic psoriasis disrupts the body's chemical balance (causing protein and fluid loss) and can cause severe illness such as Infection, pneumonia or congestive heart failure. This particularly inflammatory form of psoriasis can be the first sign of the disease, but often develops in patients with a history of plaque psoriasis. The body's temperature regulation is often disrupted, producing shivering episodes. People with severe cases of this condition are often hospitalized.

Psoriatic psoriasis. Between 10% and 30% of patients with psoriasis develop a complication called psoriatic arthritis. This type of arthritis can be slow to develop and mild or it can develop rapidly. It causes inflammation in and around the joints. People with psoriatic arthritis experience progressive joint pain and swelling, stiffness, or throbbing as well as swelling in the toes and ankles; pain in the digits, lower back, wrists, knees, and ankles; eye inflammation or pink eye (conjunctivitis).

Scalp Psoriasis: Scalp Psoriasis relates to almost 50% of the patients suffering from psoriasis. Generally it affects the back of your head, but may occur in other parts of your scalp, or on the whole scalp. Scalp psoriasis is a form of plaque psoriasis characterized by silvery white scaling over red and elevated lesions. Some people find scalp psoriasis, extremely itchy, while others have no discomfort. In extreme cases it can cause hair loss, but not permanent balding.

Nail Psoriasis: Nail psoriasis is more common in people who also have psoriatic arthritis and occurs both in the toenails and fingernails. It affects between 25-50% of people suffering from psoriasis. The most common nail changes are small nail indents of various depth, size and shape called "pitting". On some occasions surrounding area is inflamed and nails tend to crumble easily by touch, on others the nails may thicken and adopt a yellowish pattern. Nails detachment is also a possible symptom of nail psoriasis.