Knowing different types of psoriasis improves discussions and decisions.

Knowing about different types of psoriasis can be a healthy start in taking charge in the management of the skin disorder. Good information can also deflect uninvited, ill-informed and well-meaning advice. These comments are often based on someone’s faulty idea of what psoriasis looks like or how it should be treated. Since people who have psoriasis are often called on to be educators, here some short descriptions of the forms psoriasis can take.

Plaque Psoriasis

Plaque psoriasis is the most common form of the skin disorder. The medical name is “psoriasis vulgaris” Vulgaris doesn’t mean that the disorder is vulgar or socially unacceptable. Instead , it is a Latin term for common or widespread. “Popular” might be another word to use. Plaque psoriasis lesions are usually red and dot-like to begin with. The eruptions enlarge and produce a silvery white surface scale. The plaques may eventually cover large areas of skin and can merge with other plaques.

Pustular Psoriasis

Pustular Psoriasis is less common, but the exact number who have it isn’t known. this form is usually seen as small blisters on the skin. The blisters are filled with white blood cells, but this is not a sign of an infection. The skin reddens, forms pustules and then scales off. In the most unusual cases, pustular psoriasis will occur during pregnancy or may start in the first year of life. There are more ordinary forms of pustular psoriasis:

• Von Zumbusch type psoriasis tends to come on in widespread areas that dry and peel over one to two days. It may appear only once or it may occur many times. Patients are usually hospitalized.
• Annular psoriasis consists of ring shaped lesions with a red, scaly pustular margin. The rapidly evolving pustules frequently last only a day before shedding. Annular psoriasis tends to be mild but chronic, lasting for months or years.
• Exanthematic psoriasis is an acute eruption of pustules and redness. It can spread suddenly usually triggered by an infection. Once the infection is treated, the psoriasis usually clears.
• Localized psoriasis is a chronic plaque psoriasis which can become unstable as pustules appear.
• Palmar-Plantar pustulosis (PPP) remains confined to the palms of the hand and the soles of the feet. It can be chronic and difficult to treat

There are other, very unusual forms of psoriasis. Acrodermatitis continua of Hallopeau is a form of palmar-plantar psoriasis. It is characterized by lesions that form on the ends of the fingers and sometimes the toes. The nails are commonly deformed.

Guttate Psoriasis

Guttate is from the Latin word gutta, meaning “drop”. The lesions look like drops that appear on the trunk , limbs, and sometimes the scalp. It is most common in children and young adults. it sometimes follows a streptococcal infection or upper respiratory infection. The eruption initially consists of red dot like formations that later cover with scale. It appears and spreads over the body within a matter of days.

Inverse Psoriasis

This type of psoriasis is found in the armpit, groin, under the breast and other skin folds. Other typical sites are the genitals and surrounding areas, the folds of the groin, and the clefts between the buttocks. Also known as “flexural psoriasis” it is seen as large, dry, vividly red, smooth plaques.

Erythrodermic Psoriasis

Erythema means reddening. This rare type of psoriasis appears as a periodic, widespread reddening of the skin. The skin exfoliates or scales off, in patches. The process causes fluid, electrolyte and protein loss. Swelling and infection may appear and large amounts of body heat are lost. Hospitalization is usually necessary. Progress is variable. Erythrodermic psoriasis can change into a more benign and localized psoriasis, remain the same or spontaneously improve.

Nail Psoriasis

Nail Psoriasis usually shows up as pits of various sizes. The nail may come loose from the finger. The nails may crumble easily.

Face Psoriasis

Face psoriasis can appear in the ear or on the eyelids, on the face. It can cause inflammation of the membrane covering the eye. Small, fine bumps can develop on the inside of the eyelid. On rare occasions it can appear in the mouth, gums, tongue, inside the cheeks or on the lips. These lesions range in color from gray to white.