Psoriasis signs and symptoms can vary from person to person but may include one or more of the following:
- Red patches of skin covered with silvery scales
- Small scaling spots (commonly seen in children)
- Dry, cracked skin that may bleed
- Itching, burning or soreness
- Thickened, pitted or ridged nails
- Swollen and stiff joints
Psoriasis patches can range from a few spots of dandruff-like scaling to major eruptions that cover large areas.
Most types of psoriasis go through cycles, flaring for a few weeks or months, then subsiding for a time or even going into complete remission.
Several types of psoriasis exist. These include:
- Plaque psoriasis. The most common form, plaque psoriasis causes dry, raised, red skin lesions (plaques) covered with silvery scales. The plaques itch or may be painful and can occur anywhere on your body, including your genitals and the soft tissue inside your mouth. You may have just a few plaques or many.
- Nail psoriasis. Psoriasis can affect fingernails and toenails, causing pitting, abnormal nail growth and discoloration. Psoriatic nails may become loose and separate from the nail bed (onycholysis). Severe cases may cause the nail to crumble.
- Scalp psoriasis. Psoriasis on the scalp appears as red, itchy areas with silvery-white scales. The red or scaly areas often extend beyond the hairline. You may notice flakes of dead skin in your hair or on your shoulders, especially after scratching your scalp.
- Guttate psoriasis. This primarily affects young adults and children. It's usually triggered by a bacterial infection such as strep throat. It's marked by small, water-drop-shaped sores on your trunk, arms, legs and scalp. The sores are covered by a fine scale and aren't as thick as typical plaques are. You may have a single outbreak that goes away on its own, or you may have repeated episodes.
- Inverse psoriasis. Mainly affecting the skin in the armpits, in the groin, under the breasts and around the genitals, inverse psoriasis causes smooth patches of red, inflamed skin. It's worsened by friction and sweating. Fungal infections may trigger this type of psoriasis.
- Pustular psoriasis. This uncommon form of psoriasis can occur in widespread patches (generalized pustular psoriasis) or in smaller areas on your hands, feet or fingertips. It generally develops quickly, with pus-filled blisters appearing just hours after your skin becomes red and tender. The blisters may come and go frequently. Generalized pustular psoriasis can also cause fever, chills, severe itching and diarrhea.
- Erythrodermic psoriasis. The least common type of psoriasis, erythrodermic psoriasis can cover your entire body with a red, peeling rash that can itch or burn intensely.
- Psoriatic arthritis. In addition to inflamed, scaly skin, psoriatic arthritis causes pitted, discolored nails and the swollen, painful joints that are typical of arthritis. Symptoms range from mild to severe, and psoriatic arthritis can affect any joint. Although the disease usually isn't as crippling as other forms of arthritis, it can cause stiffness and progressive joint damage that in the most serious cases may lead to permanent deformity.
When to see a doctor
If you suspect that you may have psoriasis, see your doctor for an examination. Also, talk to your doctor if your psoriasis:
- Progresses beyond the nuisance stage, causing you discomfort and pain
- Makes performing routine tasks difficult
- Causes you concern about the appearance of your skin
- Leads to joint problems, such as pain, swelling or inability to perform daily tasks
Seek medical advice if your signs and symptoms worsen or don't improve with treatment. You may need a different medication or a combination of treatments to manage the psoriasis.
June 17, 2015
- Bolognia JL, et al. Dermatology. 3rd ed. Philadelphia, Penn.: Saunders Elsevier: 2012. https://www.clinicalkey.com. Accessed Dec. 6, 2013.
- Longo DL, et al. Harrison's Online. 18th ed. New York, N.Y.: The McGraw-Hill Companies; 2012. http://www.accessmedicine.com/resourceTOC.aspx?resourceID=4. Accessed Dec. 6, 2013.
- Papadakis MA, et al. Current Medical Diagnosis & Treatment 2013. 52nd ed. New York, N.Y.: The McGraw-Hill Companies; 2013. http://www.accessmedicine.com/resourceTOC.aspx?resourceID=1. Accessed Dec. 6, 2013.
- Psoriasis. National Institute of Arthritis and Musculoskeletal and Skin Diseases. http://www.niams.nih.gov/Health_Info/Psoriasis/.Accessed Dec. 8, 2013.
- Weigle N, et al. Psoriasis. American Family Physician. 2013;87:626.
- Feldman SR, et al. Epidemiology, clinical manifestations, and diagnosis of psoriasis. http://www.uptodate.com/home. Accessed Dec. 6, 2013.
- Armstrong AW, et al. The association between psoriasis and obesity: A systematic review and meta-analysis of observational studies. Nutrition and Diabetes. 2012;2:1.
- Korman N. Comorbid disease in psoriasis. http://www.uptodate.com/home. Accessed Nov. 16, 2013.
- Azfar RS, et al. Increased risk of diabetes mellitus and likelihood of receiving diabetes mellitus treatment in patients with psoriasis. Archives of Dermatology. 2012;148:995.
- Armstrong AW, et al. Coronary artery disease in patients with psoriasis referred for coronary angiography. American Journal of Cardiology. 2012;109:976.
- Ahlehoff, et al. Psoriasis and risk of atrial fibrillation and ischaemic stroke: a Danish nationwide cohort study. European Heart Journal. 2012;33:2054.
- Yeung H, et al. Psoriasis severity and the prevalence of major medical comorbidity: A population-based study. JAMA Dermatology. 2013;149:1173.
- Wan J, et al. Risk of moderate to advanced kidney disease in patients with psoriasis: population based cohort study. BMJ. 2013;347:1.
- Papoutsaki M, et al. Treatment of psoriasis and psoriatic arthritis. Biodrugs. 2013;27:3.
- Feldman SR, et al. Treatment of psoriasis. http://www.uptodate.com/home. Accessed Dec. 6, 2013.
- Almutawa F, et al. Systematic review of UV-based therapy for psoriasis. American Journal of Clinical Dermatology. 2013;14:87.
- De Migeul R, et al. Efficacy, safety, and cost of Goeckerman therapy compared with biologics in the treatment of moderate to severe psoriasis. International Journal of Dermatology. 2009;48:653.
- Garcia-Perez ME, et al. New therapies under development for psoriasis treatment. Current Opinion in Pediatrics. 2013;25:480.
- Korteum KR, et al. Results of Goeckerman treatment for psoriasis in children: A 21-year retrospective review. Pediatric Dermatology. 2010;27:518.
- Aloe. Natural Medicines Comprehensive Database. http://www.naturaldatabase.com. Accessed Dec. 9, 2013.
- Fish oil. Natural Medicines Comprehensive Database. http://www.naturaldatabase.com. Accessed Dec. 9, 2013.
- Oregon grape. Natural Medicines Comprehensive Database. http://www.naturaldatabase.com. Accessed Dec. 9, 2013.