Types of Psoriasis
Pustular and Inverse Psoriasis
Types of Psoriasis
From left to right: Erythmodermic, Plaque and Guttate Psoriasis
Types of Psoriasis
From left to right: Plaque, Erythmodermic, and Pustular Psoriasis

Psoriasis (sore-EYE-ah-sis) is a medical condition that occurs when skin cells reproduce too quickly. Instead of the usual 28 days or so, the cells replicate within days due to faulty signals in the immune system. The body does not shed these excess skin cells, so the cells pile up on the surface of the skin and lesions form.

1. Signs and Symptoms
Lesions vary in appearance according tothe type of psoriasis. There are various types of psoriasis such as plaque, guttate, pustular, inverse and erythrodermic.

The vast majority (80% or so) of people living with psoriasis have plaque psoriasis, also called “psoriasis vulgaris.” Plaque psoriasis causes patches of thick, scaly skin that may be white, silvery, or red. Called plaques, these patches can develop anywhere on the skin but commonly on the elbows, knees, lower back, and scalp.

Psoriasis can also affect the nails and about half of those who have psoriasis see a change in their finger and or toe nails. If the nails begin to pull away from the nail bed or develop pitting, ridges, or a yellowish-orange color, this may be a sign of psoriatic arthritis. Left untreated, this condition can progress and become debilitating. It is important to see a dermatologist if nail changes begin or joint pain develops. Early treatment can prevent joint deterioration.

2. Causes
It is important to note that psoriasis is NOT contagious, so you cannot get it from touching or being in the company of someone.

Psoriasis is a complex disease and scientists are still unraveling its mysteries. We know the immune system and genes are involved.

We know that when a person has psoriasis, the T-cells ( white blood cells that fight invaders such as bacteria and viruses) mistakenly trigger a reaction in the skin cells. Some people refer to psoriasis as a “T cell-mediated disease.”

This reaction activates a series of events, causing new skin cells to form in days rather than weeks we referred to earlier. Our DNA seems to trigger this reaction. Thus people who have psoriasis have inherited the genes that cause psoriasis. Scientists are still figuring out which genes are involved. One of the genes that has been identified is called PSORS1.

We also know that not everyone who inherits the psoriasis genes develops psoriasis. For psoriasis to manifest, a person must inherit the “right” mix of genes and be exposed to a trigger. Some common triggers include :

  • stressful life events

  • skin injury

  • strep throat.

Many people say that that their psoriasis first appeared after experiencing one of these. What triggers psoriasis in one person may not cause psoriasis to develop in another.

3. Who Gets Psoriasis?
Psoriasis is estimated to affect 1%–3% of the world’s population. It is a distressing chronic inflammatory skin disorder has an unpredictable course. After onset, it may remain localized or become generalized over much of the body’s surface. Psoriasis lesions are sharply delineated, pink or dull-red. Silvery scales, which are easily removed, overlay the lesions. If removed, the scales become friable and powdery. Lesions may appear at any age, but the two peaks for onset are ages 16–22 and 57–60. Psoriasis may appear for the first time or recur after childbirth.

We have said earlier that psoriasis has a genetic element and it seems that over 50% of all psoriasis sufferers have a positive family history of the disease. If one parent is affected, offspring have a 25%% greater chance of developing psoriasis, while if both parents are affected, the probability increases to 65%. The disease occurs in all racial groups and psoriasis shows no preference for socio-economic class or gender. Having said that, research also shows that Caucasians develop psoriasis more frequently than other races. A study conducted in the United States found the prevalence was 2.5% in Caucasians and 1.3% in African Americans.

4. How does psoriasis affect quality of life?

For some people, psoriasis is simply a nuisance while others find that psoriasis affects every aspect of their daily life. The unpredictable nature of psoriasis may be the reason. Psoriasis is a chronic (life-long) medical condition. Some people have frequent flare-ups that occur weekly or monthly. Others have occasional flare-ups. 

When psoriasis flares, it can cause severe itching and pain. Sometimes the skin cracks and bleeds. When trying to sleep, cracking and bleeding skin can wake a person frequently and cause sleep deprivation. A lack of sleep can make it difficult to focus at school or work. Sometimes a flare-up requires a visit to a dermatologist for additional treatment.  It is important to take the time to visit a doctor and  to get treatment. 

These cycles of flare-ups and remissions often lead to feelings of sadness, despair, guilt and anger as well as low self-esteem. Depression is higher in people who have psoriasis than in the general population. Feelings of embarrassment also are common.

5. Knowledge is Power
Because psoriasis is a life-long condition, it is important to take an active role in managing it. Psoriasis will manage the patient if the patient does not manage the condition.

Learn more about psoriasis, see a medical practitioner or dermatologist to discuss treatment options, speak to other psoriasis patients and develop a healthy lifestyle to enjoy life to the fullest. Finally, consider joining a psoriasis support group. It may well be worth your while.