What Are The Different Types Of Psoriasis

What Is Scalp Psoriasis

Scalp psoriasis shows up as itchy, scaly patches on the scalp that may bleed if you try to remove them.

About half of people who have psoriasis have it on their scalp.

At the onset, scalp psoriasis often is confused with seborrheic dermatitis . Dandruff is a flaky, itchy scalp without signs of inflammation .

Scalp psoriasis can spread beyond the hairline and affect the forehead, back of the neck, and areas around the ears.

Often psoriasis in kids is first found on the scalp.

Additional reporting by George Vernadakis

What You Should Know About Scalp Psoriasis

If youre scratching your head over an itchy scalp condition that wont clear up with a traditional dandruff shampoo, you may have scalp psoriasis. This type can go hand-in-hand with plaque psoriasis , or even appear in those who dont have any history of the skin disorder at all.

Its often confused with dandruff, because, well, it itches and causes flakes, only these flakes are typically silvery-white and scaly. You might also have painful red scales or silver plaques on your head. In severe cases, scalp psoriasis appears as thickened, crusty patches of skin not only on the hairline, but also on the forehead, back of the neck and near the ears.

How Is Scalp Psoriasis Treated

Scalp psoriasis can cause a lot of discomfort and embarrassment to the person suffering from it. However, treatment can bring relief to some extent. While some people may get relief from a medicated shampoo or solution, others may have to consult a dermatologist.

The following types of treatment can help reduce scalp psoriasis:

• Medicines applied to the scalp, which may include:
• Zithranol-RR

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Guide: 5 Different Types Of Psoriasis Explained

Psoriasis is an immune system mediated disease that causes excessive skin cell production resulting in patches of thick, itchy, inflamed, and sometimes painful skin. But did you know that not all psoriasis is the same? In fact, there are more than 5 types of psoriasis and symptoms can affect more than just the skin. Unfortunately there is no cure for psoriasis, and naturally, there is no one skin solution that works for everyone.

This guide is not a replacement for consulting with your doctor or specialist for a proper diagnosis but instead, a starting place to help you better understand psoriasis and your skin.

Lets take a look at the 5 main types of psoriasis.

Plaque Psoriasis

When most people think of the term psoriasis, they are likely referring to a condition called Plaque psoriasis. Thats because about 80% of people who suffer from psoriasis have plaque psoriasis. Its characterized by raised red, inflamed skin with white or grey plaque-like scales appearing over the rash. It can affect any area of the skin but it is most common among the elbows, knees, scalp, and back.

CAUSE

The cause of plaque psoriasis is a combination of both genetic and environmental factors. Genetics plays a large role in the disease as one-third of those with plaque psoriasis also have a relative with the disease. Environmental factors such as stress, skin trauma or injury, infection, and allergic reaction to certain medications can also lead to plaque psoriasis.

TREATMENT

CAUSE

TREATMENT

Does This Mean I Will Have Psoriasis For Life

In the absence of a cure you will always have psoriasis, but this does not mean that the signs will always be visible. Normally, the rash tends to wax and wane . There will be periods when your skin is good, with little or no sign of psoriasis. Equally, there will be times when it flares up. The length of time between clear skin and flare-ups differs for each individual and is unpredictable. It may be weeks, months or even years.

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What Type Of Psoriasis Treatment Will I Need

Several treatment options can relieve psoriasis. Creams or ointments may be enough to improve the rash in small areas of skin. If the rash affects larger areas, or you also have joint pain, you may need other treatments. Joint pain may be a sign that you have arthritis.

Your provider will decide on a treatment plan based on:

• Severity of the rash.

• Vitamin A or retinoid creams.

What You Should Know About Erythrodermic Psoriasis

The rarest of all psoriasis types, erythrodermic psoriasis affects only 2% of those with psoriasis. This type causes redness from head to toe, as if your skin has been burned. Even worse, its possible that your skin could peel off in sheets.

As with the pustular type, erythrodermic psoriasis severely compromises the skins protective barrier, so swift medical attention is a must. You can also develop fever, chills, swollen, painful joints, and rapid heart rate.

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What Is Guttate Psoriasis

Guttate psoriasis is the second most common psoriasis type.

It affects about 10 percent of people with psoriasis, according to the National Psoriasis Foundation .

Guttate psoriasis, from the Latin for raindrop shaped, causes small, dot-like spots on the body. These lesions frequently appear on the upper arms, trunk, thighs, or scalp.

Often, this form of psoriasis starts in childhood or young adulthood.

Guttate psoriasis can be triggered by a strep infection, tonsillitis, stress, a skin injury, or certain medication . Sometimes genetic factors are to blame.

Guttate psoriasis may clear up on its own, but certain cases require treatment. Some patients may experience guttate psoriasis just once, while others may find it leads to plaque psoriasis.

What Else Should I Know

Making healthy choices can help with psoriasis. Here are some things you can do:

• If you smoke, quit. Smoking can trigger outbreaks of psoriasis in some people.
• Avoid alcohol. It can make psoriasis treatments less effective.
• Eat healthy foods. Eating a lot of fruits and vegetables can help fend off diseases that might trigger psoriasis.
• Stay at a healthy weight. This decreases the risk of inverse psoriasis.
• Keep skin clean and well moisturized. Bathing daily with bath salts or oils and then applying moisturizer can help ease the symptoms of psoriasis.

People who have psoriasis may feel self-conscious about how it looks. That’s one reason why some people turn to a therapist or join a support group of people who understand what they might be going through.

The key to psoriasis treatment is keeping up on whatever your doctor prescribes. If that means applying an ointment twice a day, then find a way to remind yourself to do it so you don’t forget. Psoriasis is one of those things that you need to stay focused on treating, even when you’re feeling OK.

Whether your psoriasis is mild or severe, learn all you can about it. Talk to your doctor or check websites like:

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How Do People Get A Second Type Of Psoriasis On Their Skin

While theres no way to predict who will develop a second type of psoriasis, some people may be more susceptible. For example, having severe psoriasis that isnt well controlled, stopping a strong medication too quickly, or getting strep throat may increase your risk.

The following explains how people who have plaque psoriasis, the most common type of psoriasis, can develop a second type of psoriasis on their skin.

Youll also find out how plaque psoriasis can turn into a different type of psoriasis.

Inverse psoriasis: Many people gain a lot of weight after getting plaque psoriasis. Researchers arent sure why this happens, but they have discovered that extra pounds can increase your risk of developing inverse psoriasis.

Inverse psoriasis only forms in areas where skin touches skin, such as the armpits, groin, or underneath the breasts. It causes smooth, bright-red patches of raw-feeling skin.

Guttate psoriasis: Some people with plaque psoriasis have developed guttate psoriasis after getting an infection, such as strep throat. Guttate psoriasis causes spots on the skin that are small, pink to salmon-colored, and scaly. These spots are often widespread, appearing on the torso, legs, and arms.

Erythrodermic psoriasis: Some people who have severe plaque psoriasis see their plaque psoriasis turn into erythrodermic psoriasis. This can happen when:

Different ways that psoriasis can affect the nails

Is There A Cure For Psoriasis

There is no cure at the moment. However, as a consequence of current research, our understanding about what happens in psoriasis is growing and new drugs are being developed. In the meantime, there are a number of treatments that are effective in keeping psoriasis under control.

The art of treating psoriasis is finding the best form of treatment for each individual. There is no single solution that is right for everyone.

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What Kind Of Doctor Treats Psoriasis

There are several types of doctors who may treat psoriasis. Dermatologists specialize in the diagnosis and treatment of skin disorders, including psoriasis. Rheumatologists specialize in the treatment of joint disorders, including psoriatic arthritis. Family physicians, internal medicine physicians, rheumatologists, dermatologists, and other medical doctors may all be involved in the care and treatment of patients with psoriasis.

Clinical Trials For Psoriasis

Before a new treatment can be registered in Australia it must undergo extensive testing. Clinical trials are used to determine the safety and effectiveness of new treatments for psoriasis. The regulations governing clinical trials in Australia make the process as safe as possible for clinical trial participants. People with psoriasis may consider volunteering to participate in a clinical trial. Participation provides volunteers with access to cutting edge treatments that are not otherwise available. General information about being part of a clinical trial can be found here. Internationally, ClinicalTrials.gov provides patients, their family members, and the public with easy and free access to information on clinical studies for a wide range of diseases and conditions. If you are interested in participating in a clinical trial, talk to your doctor.

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How Do You Treat Plaque Psoriasis

There are several treatments that target plaques. Your physician will decide which one is right for you based on your general health, any underlying conditions, and the severity of your plaque psoriasis. Your options include:

• Topical ointments and creams such as cortisone cream, oral or injectable corticosteroids

• Light therapy

• Systemic drugs such as Gengraf and Sandimmune and Rasuvo and Rheumatrex

• Biologic medications, which are made from living organisms and work by slowing down your overactive immune system

Research suggests that biologics for psoriasis might help with those other inflammatory diseases linked to the skin condition, too. A study in Cardiovascular Research found that treating psoriasis with biologics helps reduce the plaque buildup in the arteries, which leads to heart attacks and strokes.

However, once your skin plaques disappear, youre not necessarily in the clear. Exposure to your triggers can bring on a new bout of plaque psoriasis. Only 10% of people are lucky enough to have whats called spontaneous remission, when your skin clears up forever and you never have a flare up again.

What You Should Know About Pustular Psoriasis

As the name implies, this type causes pus-filled bumps. These white spots can appear anywhere on your body, but most commonly the hands and feet. The bumps come on suddenly and look infected, but theyre not.

The real danger here is damage to the skins barrier, the outermost protective layer of your skin. That means your skin cant retain water or nutrients, while also allowing bacteria and other irritants to get a fast pass into your body. As a result, in some cases, pustular psoriasis can be deadly, so make an appointment with your doctor asap, if you develop it.

There are a few sub-types of pustular psoriasis:

• Von Zumbusch: This form features pustules that appear and then dry up, leaving skin with a glazed look.

• Palmoplantar pustules: This version shows up on the palms of your hands and the soles of your feet.

• Acropustulosis: This type is characterized by pustules that burst and ooze. In severe cases, this type can cause bone or nail deformity.

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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.

Different Types Of Psoriasis

Different Types of Psoriasus can appear on different parts of the body. Some of the most common areas are elbows, knees, and genitals. Although there are other sites that are commonly affected, these are the most common. Here are some things to know about these lesions. You can tell if you have them if they have scales or pus. It is also helpful to know whether you have pustular or guttate psoriasis.

Plaque psoriasis is the most severe type, affecting more than 75 percent of the body. It looks like skin that has been burned. This form of psoriasis can be painful and can lead to heart problems. The condition can also damage your nails and make them crumble. Fortunately, there is currently no cure for this disease. If you have it, however, its best to find a doctor to help you deal with it.

Symptoms of psoriasis include red, scaly patches of skin, and even a few joints. While the disease is common, it may be harder to identify than eczema. For this reason, its a good idea to see a doctor if you suspect you have the condition. A dermatologist is a good place to start.

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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.

Skins Sympathetic Fibers: Neuroendocrin Regulation

The skin is a complex organ containing afferent and efferent neural networks, glands, blood vessels, smooth muscle elements, connective tissues and immune cells, many of which are modulated by catecholamines and glucocorticoid hormones. Glucocorticoids and catecholamines reach skin tissues as circulating hormones and catecholamines are released in skin by projections of the sympathetic nervous system. The sympathetic division of the autonomic nervous system within the skin is supplied by postganglionic fibers of the paravertebral chain ganglia. Catecholamines also are produced locally by keratinocytes .

3.2.1. Skins Beta2 adrenergic receptors

3.2.2. -ARs signaling cascade

In skin, it has been proposed that epinephrine activates keratinocyte beta2AR to modulate calcium influx and begin the differentiation cascade crucial to the native architecture of the epidermis . The beta2AR desensitizes upon repeated activation through several mechanisms, including downregulation of the number of beta2AR receptors . Indeed, beta2AR expression is more highly expressed at the basal layers of the epidermis and decreases in expression toward the stratum corneum , suggesting that epinephrine may be activating the receptor to increase intracellular calcium levels and induce differentiation.

3.2.3. 2 adrenergic receptor : Phosphodiesterase

3.2.4. 2 adrenergic receptor : cAMP & Calcium

Summary 2: Psoriasis & 2 adrenergic receptor

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What Is Plaque Psoriasis

Plaque psoriasis, also called psoriasis vulgaris, is the most common type.

Between 80 percent and 90 percent of people with psoriasis have this form, according to the American Academy of Dermatology.

Plaque psoriasis is characterized by raised, scaly patches of skin. On white skin, the patches, known as plaques, are often red or pink, with silvery-white scale. On skin of color plaques may appear salmon with silvery-white scale, or violet or dark brown with gray scale.

Plaques can crop up on any area of the body but are commonly found on the knees, elbows, scalp, or back.

The plaques can cause:

Psoriasis Beyond The Basics

There are many different types of psoriasis, including chronic plaque psoriasis, types of pustular psoriasis , guttate psoriasis, scalp psoriasis, flexural psoriasis, napkin psoriasis, nail psoriasis and erythrodermic psoriasis .

For those that have psoriasis around 1 in 4 may develop an associated psoriatic arthritis , which is about 325,000 people, or around 0.5% of the UK population. PsA causes pain and swelling in the joints and tendons, accompanied by stiffness particularly in the mornings. The most commonly affected sites are the hands, feet, lower back, neck and knees, with movement in these areas becoming severely limited.

Not all people will be affected in the same way and doctors will class the condition as mild, moderate or severe.

Remember, although psoriasis is a chronic condition, it can be controlled and go into remission .

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How Is Psoriasis Diagnosed And Treated

Psoriasis often has a typical appearance that a primary care doctor can recognize, but it can be confused with other skin diseases , so a dermatologist is often the best doctor to diagnose it. The treatment of psoriasis usually depends on how much skin is affected, how bad the disease is , or the location . Treatments range from creams and ointments applied to the affected areas to ultraviolet light therapy to drugs . Many people who have psoriasis also have serious health conditions such as diabetes, heart disease, and depression. Some people with psoriasis also have an inflammatory condition which affects their joints, called psoriatic arthritis.

Psoriatic arthritis has many of the same symptoms as other types of arthritis, so a rheumatologist is often the best doctor to diagnose it. The treatment of psoriatic arthritis usually involves the use of drugs .

Psoriatic disease may be treated with drugs or a combination of drugs and creams or ointments.