What is Psoriasis?

Thickened, Scaly, Red Skin Plaques

Psoriasis is a chronic, immune-mediated inflammatory skin disease that typically affects sufferers to various extents throughout their entire lives. The characteristic red, scaly plaques of clearly defined, thickened skin may appear at any age and affect 2-4% of the population. Genetic associations have been identified that affect the type of psoriasis expressed, as well as its responsiveness to treatment. Without treatment, psoriasis is extremely persistent.

Symptoms of Psoriasis

Generally, the symptoms of psoriasis are primarily identified as the appearance of symmetrically distributed scaly red plaques on the skin surface. These will have well-defined borders. The scales themselves appear silvery-white. In skin folds, the scales appear shiny and moist, with a peeling surface. They can appear anywhere on the body, with the scalp, knees, and elbows being common sources of presence.

  • Itchy
  • Lichenification (Thickened Skin)
  • Skin Cracks and Fissures
  • Pale or Brown Marks Last for Months After Plaques Heal

Types and Patterns of Psoriasis

Several types of and patterns of psoriasis are recognized, with classifications including early or late onset; acute, guttate, or chronic; localized or generalized; small v. large plaques; thin v. thick plaques; nail v. lack of nail involvement.

Post-Streptococcal Acute Guttate Psoriasis: Small plaques in a widespread distribution over entire body; may self-resolve after a few months

Small Plaque Psoriasis: Typically, late onset (50+ years) with small plaques of less than 3 cm

Chronic Plaque Psoriasis: A very persistent psoriasis that is resistant to treatment; Plaques are larger than 3 cm and distribution ranges from mild to complete coverage, with the most commonly affected areas being the elbows, knees, and lower back

Unstable Plaque Psoriasis: Appears following stress, infections, drug exposure, and withdrawal; new plaques appear at injury sites; rapid growth

Flexural Psoriasis: Characterized by smooth, well-defined patches that inhabit the folds of the body (including genitals); commonly colonized by candida yeast

Scalp Psoriasis: This is where psoriasis initially appears for many; may remain localized

Sebopsoriasis: Psoriasis with seborrheic dermatitis; colonized by malassezia fungi; scalp, ears, face, and chest may be affected

Palmoplantar Psoriasis: Affects palms of hands and/or soles of feet; keratoderma (thickening) and painful fissuring involved

Nail Psoriasis: Ridged, pitted, yellow nails with onycholysis (nail lifted from nail bed); Comorbid with inflammatory arthritis

Erythrodermic Psoriasis: A rare form of psoriasis that may become systemic; symptoms include inability to regulate body temperature and electrolytes; May lead to cardiac failure

Medical Care and Treatments for Psoriasis

All psoriasis patients should make an effort to maintain a healthy body weight and diet, avoid alcohol, and stop smoking. In addition to prescription treatments and professional medical care, many psoriasis patients benefit from regular application of emollients, coal tar cleansers and lotions, salicylic acid, vitamin D (calcipotriol), topical corticosteroids, and phototherapy. Ask your doctor if these are right for you and your specific condition. Contact Allegheny Advanced Dermatology Center to schedule an appointment. Call: (814) 944-7109.