Psoriasis – Symptoms, Types, And Treatment
Psoriasis is a chronic autoimmune inflammatory disorder, mostly presenting with dermatological findings but can involve other parts of the body as well.
The hallmark of the disease is red or silvery itchy patches on the flexor surfaces (around the elbows, near the knees) of your body. These rashes are episodic in pattern and come and go often.
Have a read below to find out the classic symptoms, types and management of the different subtypes of psoriasis below:
The most common presentation of psoriasis is with:
· Red patches on the skin
· Silverish, often scaly patches of underlying skin
· Itching and discomfort over the area of the rash
· Swelling, stiffness and pain in different joints of the body (commonly seen in psoriatic arthritis)
· Mental stress, anxiety and depression in a subset of patients.
The symptoms of psoriasis also vary considerably based on the type involved, as mentioned below.
Types of Psoriasis
1. Plaque psoriasis
Also known as Psoriasis vulgaris, this subtype is the most common form of the diseases, affecting up to 80% of patients. It is diagnosed mostly on dermatological findings of a reddish or silver scaly itchy rash commonly involving the elbows, knees, scalp and the back area. Depending on the severity, these patches can be up to 10 cm wide, completely covering the body.
Psoriatic rashes can be extremely discomforting and debilitating for the patient. Usually an over the counter emollient or cortisone cream reduces the symptoms. Other Treatments include Vitamin D creams like Calcitriol to reduce cell turn over, Topical retinoids to reduce inflammation, Tazarotene and topical application of coal tar in the form of creams or oils.
2. Guttate Psoriasis
Guttate psoriasis usually appears in the form of small red spots on the body. The rash is not as extensive as plaque psoriasis, but can progress overtime. Rashes are usually small, miniscule, red tear drop shaped usually found over the torso in limbs. Guttate psoriasis is usually found in young adults and children. Common triggers include infection, medications, strep throat and stress.
More commonly identifying the underlying cause helps in treatment. Moreover, doctors may prescribe light therapy, steroid creams and a course of antibiotics if a bacterial infection is the causative factor.
3. Flexural/Inverse Psoriasis
This type of psoriasis is commonly found in the skin folds, such as the groin, armpits and the area underlying the breasts. The rash is often bright red with a smooth and shiny outline. Flexural psoriasis is often misdiagnosed as a fungal or bacterial infection.
Management options are similar to plaque psoriasis i.e oral medications, steroid creams and topical retinoids. You may also benefit from antibacterial and antifungal ointments.
4. Pustular Psoriasis
Pustular psoriasis is a severe subtype of the disease, characterized by rapidly developing small pustules all over the body or limited to one area of the body. These pus filled rashes can join together to form scaling. Other symptoms include high grade fever with rigors and chills, rapid pulse and associated weakness.
Treatments includes topical steroid creams for smaller patches and light therapy and oral steroids for larger patches.
5. Psoriatic Arthritis
Psoriatic arthritis is a painful debilitating condition in which the joints become affected due to systemic complications of psoriasis. Because of its autoimmune character, the joints may be severely affected limiting range of motion and physical activity. More commonly, the small joints of the hands become affected.
Treatments for psoriatic arthritis include Non-steroidal anti-inflammatory drugs such as ibuprofen and naproxen. Oral medications such as prednisolone may be frequently advised. Other topical agents include salicylic acid, tazarotene and calcipotriene. A unique category of drugs used to combat severe autoimmune conditions of the joint, known as disease-modifying antirheumatic drugs (DMARDs) can help slow disease progression.
6. Erythrodermic Psoriasis
Also known as exfoliative psoriasis, it is a rare but severe subset of the disease similar to 4th degree burns. This is a medical emergency and you may need immediate hospitalization because of the risk of infections and inability to regulate body temperature. This form of psoriasis is often widespread, involving large areas of the body. There is the sudden development of large patchy rashes with subsequent exfoliation. Erythrodermic psoriasis can commonly occur due to complicated plaque or pustular psoriasis, sunburns, alcoholism and sudden discontinuation of psoriatic medications.
Immediate management in the emergency in the form of intravenous fluids and oral medications is advised. Application of moist dressings, topical steroid creams and systemic medications can help alleviate symptoms.