Types of Psoriasis Skin Disease

Types of Psoriasis

PLAQUE PSORIASIS: Most common form of the disease
Psoriasis is a very diverse skin disease that appears in a variety of forms. Each form has distinct characteristics. Typically, people have only one type of Psoriasis at a time, but occasionally two or more different types of Psoriasis can occur at the same time. Psoriasis can also occasionally change from one form to another. Trigger factors may "convert" some forms of Psoriasis, such as plaque, to another form, such as pustular. Generally, one type of Psoriasis will clear and then another form of Psoriasis will appear later.

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GUTTATE PSORIASIS : Appears as small red spots on the skin
Guttate [GUH-tate] Psoriasis is a form of Psoriasis that often starts in childhood or young adulthood. The word guttate is from the Latin word meaning "drop." This form of Psoriasis resembles small, red, individual spots on the skin. Guttate lesions usually appear on the trunk and limbs. These spots are not usually as thick as plaque lesions.
Guttate Psoriasis often comes on quite suddenly. A variety of conditions have been known to bring on an attack of guttate Psoriasis, including upper respiratory infections, streptoccocal infections, tonsillitis, stress, injury to the skin and the administration of certain drugs (including antimalarials and beta-blockers). A streptococcal infection of the throat (strep throat) is a common guttate Psoriasis trigger. Strep throat can be present without symptoms and can still cause a flare of guttate Psoriasis. Talk with your doctor about getting a strep test to determine if you have an underlying strep infection. Guttate Psoriasis may persist despite clearance of the strep infection. Some doctors prescribe antibiotics to help prevent an occurrence of an infection that can cause the outbreak of guttate Psoriasis.

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INVERSE PSORIASIS : Occurs in armpits, groin and skin folds
Inverse Psoriasis is found in the armpits, groin, under the breasts, and in other skin folds around the genitals and the buttocks. This type of Psoriasis 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 is particularly subject to 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.
Sometimes a product called Castellani's Paint (prescribed by a doctor and compounded by a pharmacist, or bought over the counter as brand name Castederm) is used to treat inverse Psoriasis. It is a liquid that can be painted on the affected skin and can help to dry moist lesions of Psoriasis in folds. The use of powders may also help to dry the moist lesions associated with inverse Psoriasis. Some people will use creams at night and powders in the morning.

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PUSTULAR PSORIASIS : White blisters surrounded by red skin
Primarily seen in adults, pustular [PUHS-choo-ler] Psoriasis is characterized by white pustules (blisters of noninfectious pus) surrounded by red skin. The pus consists of white blood cells. It is not an infection, nor is it contagious. It may be localized to certain areas of the body–for example, the hands and feet. Pustular Psoriasis also can be generalized, covering most of the body. It tends to go in a cycle–reddening of the skin followed by formation of pustules and scaling.
Pustular Psoriasis reportedly may be triggered by internal medications, irritating topical agents, overexposure to UV light, pregnancy, systemic steroids, infections, emotional stress and sudden withdrawal of systemic medications or potent topical steroids. 

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ERYTHRODERMIC PSORIASIS : Intense redness over large areas
Erythrodermic [eh-REETH-ro-der-mik] Psoriasis is a particularly inflammatory form of Psoriasis that often affects most of the body surface. It may occur in association with von Zumbusch pustular Psoriasis. It is characterized by periodic, widespread, fiery redness of the skin. The erythema (reddening) and exfoliation (shedding) of the skin are often accompanied by severe itching and pain.
Patients having an erythrodermic Psoriasis flare should make an appointment to see a doctor immediately. Erythrodermic Psoriasis causes protein and fluid loss that can lead to severe illness. Edema (swelling from fluid retention), especially around the ankles, may also develop along with infection. The body's temperature regulation is often disrupted, producing shivering episodes. Infection, pneumonia and congestive heart failure brought on by erythrodermic Psoriasis can be life threatening. People with severe cases of this condition often require hospitalization. 
Known triggers of erythodermic Psoriasis include abrupt withdrawal of systemic treatment; the use of systemic steroids (cortisone); an allergic, drug-induced rash that brings on the Koebner response (a tendency for Psoriasis to appear on the site of skin injuries); and severe sunburns.

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About 10 percent to 30 percent of people with Psoriasis also develop psoriatic [pronounced sore-ee-AA-tic] arthritis, which causes pain, stiffness and swelling in and around the joints.
Early recognition, diagnosis and treatment of psoriatic arthritis can relieve pain and inflammation and possibly help prevent progressive joint involvement and damage. Without treatment, psoriatic arthritis can potentially be disabling and crippling.

Psoriatic arthritis is associated with Psoriasis on the skin. Approximately 10 percent to 30 percent of people with Psoriasis develop psoriatic arthritis, although it often may go undiagnosed, particularly in its milder forms. It can develop at any time, but for most people it appears between the ages of 30 and 50. Psoriatic arthritis seems to affect men at a slightly higher percentage than women.
Both genetic and environmental factors seem to be associated with the development of psoriatic arthritis. The immune system plays an important role.
Prompt diagnosis and treatment can relieve pain and inflammation and possibly help prevent progressive joint involvement and damage. Without treatment, psoriatic arthritis can potentially be disabling and crippling.
Psoriatic arthritis can develop slowly with mild symptoms, or it can develop quickly and be severe. Early recognition, diagnosis and treatment of psoriatic arthritis can help prevent or limit extensive joint damage that occurs in later stages of the disease.

Generally, one or more of the following symptoms appears
» Generalized fatigue
» Tenderness, pain and swelling over tendons
» Swollen fingers and toes
» Stiffness, pain, throbbing, swelling and tenderness in one or more joints
» A reduced range of motion
» Morning stiffness and tiredness
» Nail changes—for example, the nail separates from the nail bed and/or becomes pitted and mimics fungus infections
» Redness and pain of the eye, such as conjunctivitis

The disease can develop in a joint after an injury and may mimic a cartilage tear. The diagnosis of psoriatic arthritis may sometimes be made only after repeated episodes. Muscle or joint pain can occur without joint inflammation (swelling). Tendonitis and bursitis may be prominent features. Swelling of the fingers and toes can suggest a "sausage-like" appearance, known as dactylitis. Psoriatic arthritis usually affects the distal joints (those closest to the nail) in fingers or toes. The lower back, wrists, knees or ankles also may be affected.