Inverse Psoriasis Vs Plaque Psoriasis

Symptoms Of Inverse Psoriasis

If you have inverse psoriasis, youâll notice red, shiny patches in certain places, like:

• Your armpits
• The skin folds around your genitals and between your buttocks
• Under your breasts
• Your groin

The skin in these areas is more sensitive, so the condition is often a challenge to manage and treat. Lesions can cause cracks in the creases of your skin, which may be painful and bleed. Because of its location, the disease may also cause:

• Irritation from rubbing and sweating
• Yeast, fungal, and bacterial infections
• Sexual problems because of discomfort

Get tips on how to treat deep cracks and protect your skin.

When To See A Doctor For Psoriasis Or Eczema

The National Psoriasis Foundation recommends that anyone living with psoriasis see a dermatologist. Its especially important to see a dermatologist if your psoriasis symptoms are getting worse, if you develop new symptoms, if your joints start to hurt, or if the treatment recommended by your primary care physician isnt working.

If you have eczema and your symptoms get worse or if you show signs of an infectionred, painful, oozing, or blistery skinthen its best to see a doctor as soon as possible. If youve seen a doctor already and the treatment plan they gave you isnt working, a dermatologist will be able to give you more specialized care.

How Can Parents Help

For some children, psoriasis is just a minor inconvenience. For others, it is a difficult medical condition.

To manage symptoms and make outbreaks less likely, your child should:

• Wash hands well and often and stay away from people who are sick to prevent infections.
• Manage stress through exercise, yoga, or meditation.
• Not smoke or drink alcohol.
• Keep a healthy weight. People who are overweight tend to have more severe psoriasis symptoms.

Kids and teens with psoriasis may feel uncomfortable with the way their skin looks. Help your child understand that psoriasis is common and treatments can help.

Whether your child’s psoriasis is mild or severe, learn about the condition together. Offer to help find a therapist or join a support group if that might help. Talk to your doctor or check websites like:

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What Are The Clinical Features Of Flexural Psoriasis

Due to the moist nature of the skin folds the appearance of the psoriasis is slightly different. It tends not to have silvery scale, but is shiny and smooth. There may be a crack in the depth of the skin crease. The deep red colour and well-defined borders characteristic of psoriasis may still be obvious.

Scaly plaques may sometimes occur however, particularly on the circumcised penis.

Flexural psoriasis can be difficult to tell apart from seborrhoeicdermatitis, or may co-exist. Seborrhoeic dermatitis in skin folds tends to present as thin salmon-pink patches that are less well defined than psoriasis. If there is any doubt which is responsible, or there is thought to be overlap of the two conditions, the term sebopsoriasis may be used.

Complications of flexural psoriasis include:

• Chaffing and irritation from heat and sweat
• Secondary fungal infections particularly Candida albicans
• Lichenification from rubbing and scratching this is a particular problem around the anus where faecal material irritates causing increased itching
• Sexual difficulties because of embarrassment and discomfort
• Thinned skin due to long term overuse of strong topical steroid creams

How Is Inverse Psoriasis Treated

Many people with inverse psoriasis find that treatment is able to reduce and even eliminate their symptoms. However, like other types of psoriasis, people with inverse psoriasis will often go through periods of remission and relapse5. During remission, the symptoms go away for a length of time after treatment, but then symptoms return during a relapse.

Topical treatments are medicines that are applied directly to the skin of the area affected by symptoms. They might be used alone or in various combinations, along with emollients to moisturize the skin and relieve discomfort.

Treatment with topical corticosteroids is a common type of treatment that people with inverse psoriasis will try. Topical corticosteroids work by reducing the amount of inflammation in the affected area. Symptoms of psoriasis are caused by excess skin cell production, which is due to inflammation. Therefore, corticosteroids can help to reduce the symptoms of inverse psoriasis.

Milder versions of topical corticosteroids are often effective against symptoms, but the symptoms tend to come back when treatment stops. Stronger versions of topical corticosteroids have a more powerful effect, but they can only be used sparingly and for a very short time because of the side effects that they can cause. For example, they can cause thinning of the skin and/or stretch marks. If overused, corticosteroids can actually make the symptoms of psoriasis worsen over time5.

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What Is Inverse Psoriasisand What’s The Best Way To Treat It

Psoriasis typically occurs on the elbows and knees, but when you have inverse psoriasis, it tends to appear as smaller, pink, sometimes itchy patches in the skin folds or creases.

Also called hidden psoriasis, this painful type of psoriasisan inflammatory condition that occurs when your skin cells multiply too quicklyappears in places on the body where the skin rubs against skin or where the skin tends to stay sweaty. It affects 2-6% of people with psoriasis.

Inverse psoriasis gets its name because this rash shows up in very specific places where skin may chafe, such as the groin, genitals and under the breasts, says Hal Weitzbuch, MD, a dermatologist in Calabasas, California.

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What If Those Psoriasis Treatments Dont Work

If psoriasis doesnt improve, your healthcare provider may recommend these treatments:

• Light therapy: UV light at specific wavelengths can decrease skin inflammation and help slow skin cell production.
• PUVA: This treatment combines a medication called psoralen with exposure to a special form of UV light.
• Methotrexate: Providers sometimes recommend this medication for severe cases. It may cause liver disease. If you take it, your provider will monitor you with blood tests. You may need periodic liver biopsies to check your liver health.
• Retinoids: These vitamin A-related drugs can cause side effects, including birth defects.
• Cyclosporine: This medicine can help severe psoriasis. But it may cause high blood pressure and kidney damage.
• Immune therapies: Newer immune therapy medications work by blocking the bodys immune system so it cant jumpstart an autoimmune disease such as psoriasis.

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What Are The Risk Factors For Inverse Psoriasis

Psoriasis isnt contagious. The exact cause of it isnt clear, but its likely a combination of genetics and a triggering event.

Youre more likely to develop psoriasis if you have a family history of the disease. Inverse psoriasis is more common in people who are obese or who have deep skin folds. People with a weakened immune system are also at a greater risk of developing the skin condition.

Skin rubbing on skin is the main cause of intertrigo, and anyone can develop it. The condition isnt contagious.

Your risk of intertrigo may increase if:

• youre regularly exposed to high heat and humidity
• you have artificial limbs, braces, or splints that rub on your skin
• youre malnourished

Who Gets Nail Psoriasis

After developing a type of psoriasis on your skin, its common for psoriasis to affect the nails. Nail psoriasis becomes more common with age. Its also more common if youve had psoriasis on your skin for some time or have severe psoriasis.

Signs of nail psoriasis include tiny dents in your nails , discoloration under one or more nails, and a nail lifting away from the nail bed so that its no longer completely attached. Some people have a buildup of skin under one or more of their nails, which can also cause a nail to lift up.

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What Can Prevent Someone From Getting A Second Type Of Psoriasis

Most types of psoriasis cannot be prevented.

That said, if you already have plaque psoriasis, it may be possible to reduce your risk of developing another type of psoriasis on your skin. Dermatologists recommend taking the following precautions:

• Protect your skin to prevent sunburn

• Take medication as directed and speak with your dermatologist before stopping a medication

• Treat your psoriasis so that its well-controlled

• Watch your weight so that you stay at a weight thats recommended for your age and height

Watching your weight may help prevent inverse psoriasis. This type of psoriasis is more common in people who are 20 or more pounds overweight.

Why Is Jock Itch Misdiagnosed As Inverse Psoriasis

Jock itch and inverse psoriasis are occasionally mistaken for each other due to their similar symptoms and appearances. Both conditions cause pain, discolored patches, and an itching sensation in and around skin folds such as the groin and buttocks.

Complicating matters is the fact that people with inverse psoriasis dont always exhibit the symptoms most commonly associated with psoriasis as a whole. The telltale signs of plaque psoriasis the most common form of psoriasis are raised, dry plaques of skin covered with silvery or gray scales. In contrast, inverse psoriasis patches are usually smooth and shiny. The moist environments they form in generally prevent them from forming characteristic scales.

If someone with a mild case of inverse psoriasis begins experiencing patches in an area often affected by jock itch, they might assume that their symptoms are caused by a fungal infection. But the best person to determine the cause of symptoms is a health care professional, like a dermatologist experienced with both fungal infections and psoriasis.

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Inverse Psoriasis Vs Intertrigo: Understanding The Symptoms

Inverse psoriasis, also known as flexural or intertriginous psoriasis, is a rare and painful form of the inflammatory skin disease psoriasis. It typically presents with smooth, shiny, discolored patches red, purplish, or brown, depending on skin tone in the armpits, under the breasts, and in the genital and anal areas. The symptoms of inverse psoriasis can resemble those of other conditions, including intertrigo inflammation caused by areas of skin rubbing together.

Inverse psoriasis can cause very similar symptoms and affect the same areas as intertrigo. In fact, inverse psoriasis may be mistaken for different types of intertrigo. That said, the two are distinct conditions with different underlying causes. If you experience new or worsened symptoms of either skin condition, talk to your health care provider or a dermatologist. They will be able to determine the cause of your symptoms and work with you to find the best ways of managing them.

Causes Of Inverse Psoriasis

Inverse psoriasis is caused by an abnormality in your immune system, just like other autoimmune diseases. But moisture and friction can trigger the symptoms of this particular type of psoriasis.

If youve got psoriasis and are overweight, youre at a higher risk of also developing inverse psoriasis. Thats because extra body weight produces excess skin and deeper skin folds.

There are several different treatment methods available for inverse psoriasis:

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What Causes Inverse Psoriasis And Intertrigo

Like other types of psoriasis, inverse psoriasis is an autoimmune condition. It occurs when an overactive immune system begins attacking healthy skin cells. These misdirected attacks cause skin cell production to speed up dramatically, which creates the painful, discolored patches of skin, scaling, and pustules characteristic of psoriasis.

Scientists believe that inverse psoriasis may be caused by a combination of genetics and environmental factors. According to the American Academy of Dermatology, people who already have plaque psoriasis and are 20 or more pounds overweight may be at greater risk for having inverse psoriasis, as well.

Some factors may also trigger a person to develop the symptoms of inverse psoriasis, including stress, infections, and skin injuries. Fungal infections, like jock itch, can also trigger inverse psoriasis.

Interestingly enough, both infections and skin inflammation can cause a person to develop intertrigo including inverse psoriasis. As with inverse psoriasis, a number of genetic and environmental factors are believed to play a role in the development of intertrigo. Living in a hot, humid climate and experiencing friction from skin-on-skin contact can cause a person to develop the condition.

Racial Disparity In Psoriasis

Psoriasis can affect persons of any race however, epidemiologic studies have shown a higher prevalence in western European and Scandinavian populations. In these groups, 1.5-3% of the population is affected by the disease.

The highest documented disease prevalence is in Arctic Kasach’ye, with 12% of the population affected, followed by Norway, where 4.8% of the population has psoriasis. Lower prevalence rates for psoriasis have been reported among Japanese and Inuit populations.

Psoriasis is thought to be rare in West Africans and African Americans and is nearly absent in North American Indians. Psoriasis was undetected in the Samoan population and in a study that examined 26,000 South American Indians.

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What Should I Do If I Have Genital Psoriasis

Genital psoriasis may also affect the surrounding area in the groin. It rarely appears in the vagina. If you develop psoriasis of the genitalia, you should always consult your doctor. Do not be embarrassed.

Genital psoriasis can sometimes look similar to a fungal or bacterial infection, or even contact dermatitis, so your doctor may need to check the diagnosis with a laboratory test before starting any treatment. The delicate skin in the genital area may mean you need a weaker psoriasis treatment than elsewhere on your body. You should bear in mind that you may be susceptible to irritation and allergic reactions from any substance applied to the skin. Sensitisation most commonly occurs from perfumes and preservatives in over-the-counter wash products and topical local anaesthetics. It is important to keep personal hygiene as uncomplicated as possible and avoid fragranced products.

It is also important to remember that your psoriasis is not due to an infection and is not catching. So, when you are in a loving relationship with a partner who knows about your psoriasis, it should not interfere with your sex life. If you are with a new partner, take the time to explain your condition before you become intimate, to reduce stress and needless worry for you both.

This article is adapted from the Genital psoriasis leaflet.

Cause & Risk Factors Of Inverse Psoriasis

Doctors arenât sure what causes psoriasis, but they know that your genes and your immune system play a major role. About 40% of people with psoriasis have at least one close relative with the disease. Many of the genes linked to psoriasis are those that help run your immune system.

In addition to your genes, these things can make you more likely to get psoriasis:

• Smoking

• Skin irritation or any injury to the skin

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Distinguishing Between Inverse Psoriasis And Intertrigo

Because the symptoms of inverse psoriasis can mimic those of other skin diseases, its often difficult to diagnose. Smooth discolored patches from skin-on-skin friction particularly in the groin can be a sign of inverse psoriasis. Other indicators of the autoimmune disease include a family history of psoriasis, psoriatic plaques in other areas of the body, and changes to the nails or nail beds.

In order to confirm a diagnosis of inverse psoriasis or intertrigo, a dermatologist will perform a physical exam and visual inspection. If they suspect an infectious form of intertrigo, they will take skin samples to test for the presence of a bacterial or fungal infection.

If you suspect that you may have inverse psoriasis or intertrigo, talk to a licensed dermatologist. They will provide you with an accurate diagnosis and proper treatment.

Treatments For Jock Itch And Inverse Psoriasis

If you have inverse psoriasis and jock itch simultaneously, you should consult your doctor about balancing treatments for both. There are prescription creams that contain antifungal ingredients as well as topical steroids to stop inflammation.

One MyPsoriasisTeam member shared advice about managing skin symptoms, You can get some hydrocortisone cream to stop the itch, or, if you think its a fungal issue, something with an antifungal in it, too, they wrote. My problems have been so severe that I am presently taking antibiotic and antifungal tablets from my general practitioner.

The medications you use will depend on the severity of your case and your unique health situation. You may need to try several different medications to find a treatment approach that works for you. Your doctor is your best guide and will be able to help you manage your symptoms long-term.

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What Are Other Types Of Psoriasis

Plaque psoriasis is the most common type. About 80% to 90% of people with psoriasis have plaque psoriasis.

Other, less common types of psoriasis include:

• Inverse psoriasis appears in skin folds. It may look like thin pink plaques without scale.
• Guttate psoriasis may appear after a sore throat caused by a streptococcal infection. It looks like small, red, drop-shaped scaly spots in children and young adults.
• Pustular psoriasis has small, pus-filled bumps on top of the red patches or plaques.
• Sebopsoriasis typically appears on the face and scalp as red bumps and plaques with greasy yellow scale. This type is a cross between psoriasis and seborrheic dermatitis.

Where Can Inverse Psoriasis Symptoms Occur

The symptoms of inverse psoriasis are smooth, pink/red, shiny areas of skin. These areas are not usually covered in scales, unlike typical plaque psoriasis symptoms that occur in other parts of the body2. Some people may develop a crack deep within the skin crease.

The most common place where inverse psoriasis symptoms occur are3:

• Under the arm and in the armpits

• Behind the ears
• In the ears

Sweating and any type of friction can both tend to make the symptoms of inverse psoriasis get worse, due to chafing and irritation. Rubbing and scratching can also worsen symptoms. People with inverse psoriasis are also more likely to get certain types of fungal, bacterial, or yeast infections4.

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