What Are The Possible Causes Of Small Scaling Spots
Most people develop the small scaling spots of guttate psoriasis after they have had an infection. It can take up to a couple of weeks after the infection for the symptoms of guttate psoriasis to develop. Strep throat, an upper respiratory infection, is the most common trigger. Fungal and viral infections can also trigger an outbreak of guttate psoriasis1.
Other people develop guttate psoriasis after taking certain types of medications, such as2:
What Are The Symptoms
There are several types of psoriasis. Symptoms for each may vary. But major symptoms are itchy and tender skin and raised, bright red patches of skin , topped with loose, silvery scales. In some people, psoriasis causes joints to become swollen, tender, and painful. Symptoms may disappear, even without treatment, and then return.
What Will Happen If I Stop Treating My Psoriasis
One of three things happens when you stop treatment:
You may stay clear and have no psoriasis symptoms .
Your psoriasis may return, looking and feeling much like it did before .
The psoriasis may return and be worse than before .
What happens often depends on the medication you were using when you stopped, how well you manage your psoriasis triggers, and your medical history.
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What Else Should I Ask My Healthcare Provider
If you have psoriasis, ask your healthcare provider:
- How can I prevent outbreaks and control symptoms?
- What medication will work best for me?
- What else should I do to improve symptoms?
- What are my options if creams dont work?
- Will psoriasis ever go away?
A note from Cleveland Clinic
Psoriasis, an itchy skin condition, can come and go throughout your life. Its related to an overactive immune response and is not contagious. If you have skin changes that arent going away, talk to your healthcare provider. There is no cure for psoriasis, but psoriasis treatments can improve symptoms. Your provider may prescribe a special cream or moisturizer or medications. Other therapies are available if creams or medicines dont work. Maintaining your overall health will also help improve symptoms.
Last reviewed by a Cleveland Clinic medical professional on 10/17/2020.
What You Can Do
Most people who get plaque psoriasis have it for the rest of their lives. You can do a few things to deal with it better:
Avoid triggers. Things like stress and smoking don’t cause psoriasis. But they can make it worse. Try to figure out what triggers your flare-ups. You may be affected by:
American Academy of Dermatology: “Psoriasis.”
Medscape: “FDA OKs Biologic Guselkumab for Plaque Psoriasis.” “Plaque Psoriasis.”
National Institute of Arthritis and Musculoskeletal and Skin Diseases: “Psoriasis.”
National Psoriasis Foundation.
UpToDate: “Treatment of psoriasis.”
Weigle, N., American Family Physician, May 2013.
Bruce E. Strober, MD, PhD. associate director of Dermatopharmacology, Department of Dermatology, New York University School of Medicine co-director of the Psoriasis and Psoriatic Arthritis Center consultant for Amgen, Biogen, Genentech, Fujisawa, and 3-M.
Jeffrey M. Weinberg, MD, director of the Clinical Research Center, St. Luke’s-Roosevelt Hospital Center, New York City assistant clinical professor of dermatology, Columbia University College of Physicians and Surgeons consultant for Amgen and Genentech.
Abel, E. “Dermatology III: Psoriasis,” ACP Medicine, April, 2005.
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Who Is Affected By Guttate Psoriasis
- Usually young people get guttate psoriasis, in their teens or twenties. Men and women are affected equally.
- It seems to occur all over the world.
- No one really quite knows how common it is. In general, a GP in the UK would have heard of it and probably know how to diagnose it, but they may not have seen a case themselves for many years.
What Are The Most Common Treatments For Psoriasis And Whats The Prognosis
The bad news is that psoriasis is chronic, so if you’re diagnosed with it, it’s likely a condition that you’ll have for life. And there is currently no cure. But there’s some very good news to keep in mind, too. Symptoms can come and go over time, and there are a variety of treatment options that are more effective than ever and can help you find significant symptom relief.
Common psoriasis treatments include:
These can include steroid creams, a vitamin D analog, or a combination.
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Articles On Types Of Psoriasis
Knowing which kind of psoriasis you have helps you and your doctor make a treatment plan. Most people have only one type at a time. Sometimes, after your symptoms go away, a new form of psoriasis will crop up in response to a trigger.
In general, most types of psoriasis result from the same triggers:
Here’s how you can spot the 7 types of psoriasis and what you can do to treat them.
What Symptoms Should You Watch For
Visually, it can sometimes be difficult to tell one condition from the other.
You have to look at all the clinical aspects of a rash to distinguish between eczema and psoriasis, including the history and the patients other medical problems, Dr. Fernandez says.
The common signs dry and/or cracked scaly skin, itching and red patches or plaques may show up for either.
With psoriasis, the plaques on your skin are likely thicker and have dry scaling. But sometimes thats not enough to tell between the two with the naked eye, Dr. Fernandez says.
A more obvious clue fluid leaking through the skin points to eczema.
When we see that, we definitely think about eczema instead of psoriasis, he says. But there are definitely times when we cannot tell the difference. And, in those cases, we will perform biopsies.
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When To Call A Doctor
- Symptoms of psoriasis. Early treatment may help keep the condition from getting worse.
- Signs of an infection, including:
- Increased pain, swelling, warmth, or redness.
- Red streaks leading from the area.
- Pus draining from the area.
- A fever.
If you are being treated for psoriasis, call your doctor if you:
- Have severe and widespread psoriasis and your skin is more irritated or inflamed than usual, especially if you have another illness.
- Are taking medicine for psoriasis and have serious side effects, such as vomiting, bloody diarrhea, chills, or a fever.
Your Skin Is Less Red And Flaky
The thick, scaly patches of skin so common with psoriasis are usually very red in color, and they may be covered with silvery, . One sign you may be headed for remission is an improvement in both the color and the flakiness of your skin. You might notice your skin is less dry, and that its less flaky than before.
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Psoriasis Is An Inflammatory Skin Condition Diagnosed By A Physician
It usually manifests as itchy, well-delineated, red, scaly plaques in locations across the body, most often the scalp, elbows and knees, Wang explains.
Patients are typically diagnosed with psoriasis in their 20s or later on in adulthood, usually based on a clinical examination and family history, and sometimes with a skin biopsy to confirm the diagnosis.
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In addition, were finding psoriasis can be associated with a variety of other health problems, particularly when its more extensive, likely because there is inflammation beyond the skin, Wang says. For instance, patients are at risk for diabetes, high cholesterol, high blood pressure, fatty liver and cardiovascular disease. It also can be associated with arthritis, which often manifests with morning stiffness. Psoriatic arthritis can hinder peoples ability to do their normal activities.
Dry Cracked Skin: Irritation That Can Lead To Infection
Dry, cracked skin is a psoriasis symptom. However, dry air can also cause your skin to become dry and itchy. When the skin is dry and irritated , it’s more likely to get infected. Infection may cause your skin to become red and swollen. If you have any skin rashes that keep coming back or won’t go away, see your doctor. Most cases of psoriasis can be diagnosed with a physical examination but because psoriasis can look like many other skin conditions, a skin biopsy may have to be done to definitively diagnose it.
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Ringworm: Fungal Infections Of The Skin And Nails
Tinea is a type of fungal infection that resembles some symptoms of psoriasis. Psoriasis can cause the thick fingernails symptomatic of fungal nail infections, and both can cause red, itchy skin rashes. When tinea grows on your skin, it can cause a scaly, red skin rash that clears in the middle, called ringworm . Fungal infections of the skin and nails can be hard to treat. Antifungal medications work, but you may need to take them for a long time.
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.
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Things A Dermatologist Wants You To Know About Psoriasis
Its a chronic skin problem with no cure, but heres what experts, and especially sufferers, want you to understand about the condition.
Psoriasis isnt just about looks, and its not contagious. And although this rash consisting of red, scaly and patchy spots is one of the more common skin diseases dermatologists see, public misunderstanding persists, says Michigan Medicine dermatologist Frank Wang, M.D.
Wang, who also directs Michigan Medicines Dermatology Treatment Center, an outpatient clinical program utilizing intensive topical therapies for psoriasis and other inflammatory skin disorders, says its important to be aware that psoriasis impacts both physical and emotional health.
Its a condition to be taken seriously, Wang says. The way patients may be treated by others who are not familiar with psoriasis can really impact their self-esteem and emotional wellbeing.
Here, Wang addresses the five facts more people should know about the condition, which has been a longtime research focus for Michigan Medicine dermatologists.
Can Psoriasis Turn Into Vitiligo
Close analysis of results, in the present work, had shown that patients with vitiligo had a higher chance to develop psoriasis while patients with psoriasis has lower chance to develop vitiligo as frequency of psoriasis among vitiligo patients was 6% while the frequency of vitiligo among psoriasis was 2% only.
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Symptoms Of Guttate Psoriasis
Guttate psoriasis can appear quickly. Symptoms include tiny red bumps that are raised, scaly, and possibly itchy. The spots typically cover the torso, arms, and legs, but can appear elsewhere on the body. Guttate lesions are not generally as thick as those of plaque psoriasis.
Diagnosis is usually made with a visual examination of lesions and a medical history. A dermatologist may order tests to confirm the diagnosis that include a throat culture and blood work to detect elevated levels of strep bacteria. A skin biopsy is sometimes performed, but usually isnt necessary.
Speak with your dermatologist if you develop guttate psoriasis after a strep throat infection.
Should Rashes Disappear When Pressed
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How Do You Tell If I Have Eczema Or Psoriasis
Subtle Differences in Itchiness
Dr. Millstein says, Psoriasis tends to cause milder itching and, in some less common types of psoriasis, a terrible burn. Eczema, on the other hand, can lead to very intense itching. When it starts to become severe, some people scratch their skin so hard that it bleeds.
Common Symptoms Of Psoriasis
Psoriasis 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
- 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. Mild cases of psoriasis may be a nuisance. But more severe cases can be painful, disfiguring and disabling. 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. In most cases, however, the disease eventually returns.
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Other Psoriasis Risk Factors Include:
- Other Medical ConditionsPeople with HIV are more likely to develop psoriasis than people with healthy immune systems are. Children and young adults with recurring infections, particularly strep throat, may also be at increased risk.
- StressBecause stress can have a strong impact on your immune system, high stress levels may increase your risk of psoriasis.
- ObesityExcess weight increases your risk of inverse psoriasis. In addition, plaques associated with all types of psoriasis often develop in skin creases and folds.
- SmokingSmoking tobacco not only increases your risk of psoriasis but also may increase the severity of the disease. Smoking may also play a role in the initial development of the disease.
When To Contact A Medical Professional
Contact your provider if you have symptoms of psoriasis or if your skin irritation continues despite treatment.
Tell your provider if you have joint pain or fever with your psoriasis attacks.
If you have symptoms of arthritis, talk to your dermatologist or rheumatologist.
Go to the emergency room or call the local emergency number if you have a severe outbreak that covers all or most of your body.
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More Than Skin Troubles
A 2017 study from the Journal of the American Academy of Dermatology found that people with psoriasis that covers 10% of their body or more are 64% more likely than those without psoriasis to develop type 2 diabetes. “About 30% of people with psoriasis also might develop psoriatic arthritis, which causes destructive inflammation in your joints,” says dermatologist Dr. Gideon Smith. Psoriasis also may signal a higher risk for fatty liver disease and heart attacks.
Laser And Light Therapy
Different types of light therapy can help reduce the risk of scarring by relieving symptoms.
Excimer laser therapy for example, XTRAC can help remove layers of skin by directing concentrated ultraviolet light to specific areas of the skin.
The advantage of laser therapy is that is targets lesions directly and does not affect other areas of the skin. Phototherapy is another option.
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What Are The Treatment Options
Though the underlying causes are different, treatment is generally similar, Dr. Fernandez says. You should see a dermatologist for any rash that doesnt go away with over-the-counter medicine, he says.
- Topical cortisone, especially if you have a mild case.
- Immunosuppressive drugs for more moderate to severe cases.
- or ultraviolet light treatment for severe cases.
Also, eczema can prompt a secondary infection so your doctor may use topical and systemic antibiotics to remove bacteria and calm the inflammation.
Update Your Treatment Plan
Psoriasis treatments can reduce inflammation, heal lesions, and help skin resume normal function. If youre having difficulty managing flares, talk with your dermatologist about new treatments to consider. We have such good medications now that many patients who have had persistent plaques for years are able to experience clear skin, says Kassouf.
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Psoriasis And Quality Of Life
Doctors and people with psoriasis donât always agree on whatâs mild and whatâs serious. Psoriasis can affect self-image and make people self-conscious. This can even lead to depression and social isolation.
Only a frank discussion with your doctor about what living with psoriasis means to you will get these issues out in the open.
Systemic Psoriasis Treatment: Balancing Risks And Benefits
The fine print on the labels for systemic treatments could give anyone concerns. Most systemic treatments target the immune system. Also:
- Biologic therapies and some oral treatments can raise the chance of having an infection, so your doctor will monitor you while you are taking them.
- Methotrexate requires monitoring for liver, bone marrow, kidney, and lung damage.
- Cyclosporine can cause kidney damage and needs to be monitored.
Each treatment has its own side effects, which you should discuss with your doctor.
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Moisturize At Least Twice A Day
Using emollients especially creams with exfoliating acids such as lactic, glycolic, or salicylic acid is key to reducing itching and scaling. It should be done in addition to whatever therapy is prescribed by your doctor, Dr. Pelle says. Apply moisturizer twice a day for the best results. You can also use it to soothe itchiness and help you resist the urge to scratch.
What Are The Clinical Features Of Facial Psoriasis
Facial psoriasis has various clinical presentations. There are three main subtypes:
- Hairline psoriasis
- An extension of scalp psoriasis beyond the hairline onto facial skin
- Bright red, thickened plaques with variable white scale
Psoriasis affecting hairline
- Patchy involvement of the hairline
- Often affects the eyelids, eyebrows, nasolabial folds and beard area
- Salmon-pink, thin plaques with bran-like scale
- Usually associated with diffuse or patchy scalp psoriasis
- Psoriasis may or may not be present at other sites
- Sharply demarcated, red, scaly plaques
- May affect any part of the face
- Plaques tend to be symmetrical
- Associated with psoriasis at other sites including ears, genitals, scalp, elbows, knees, and trunk
- Soreness and skin sensitivity, which are usually mild
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