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Can You Have More Than One Type of Psoriasis?

New symptoms could be a different type of psoriasis or another skin disorder.

Can You Have More Than One Type of Psoriasis?

Plaque psoriasis is the most common type of psoriasis. Between 80 and 90 percent of people with psoriasis have this type, which manifests as lesions of thickened, reddened, inflamed skin that can have a silver, scaled appearance. These lesions are called plaques and most often show up on the elbows, knees, back, and scalp, though they can appear on other areas of the body as well. These symptoms are common enough that plaque psoriasis is sometimes simply referred to as psoriasis.

But there are other types of psoriasis, which have different symptoms. It’s possible for a person to have more than one type of psoriasis at the same time and for psoriasis symptoms to change over time. Here, we look at the different types of psoriasis and what to do if you notice new skin symptoms.

Types of psoriasis and symptoms
In addition to plaque psoriasis, the other major forms of psoriasis are:

  • Inverse psoriasis. With inverse psoriasis, lesions are red, shiny, and smooth. These lesions affect areas of the body where skin folds against skin, such as the underarms, under the breasts, the groin, and the buttocks. While it can occur on its own, inverse psoriasis more commonly occurs when a person also has plaque psoriasis or other psoriasis symptoms on other areas of their body.
  • Guttate psoriasis. Guttate psoriasis is the second-most common type of psoriasis and is an example of how psoriasis symptoms can change over time—up to 40 percent of people who have guttate psoriasis develop plaque psoriasis. This type causes small lesions that are red, scaled, and round or drop-shaped. These lesions can appear on the arms, legs, and torso. Guttate psoriasis is most common in children and people under the age of 30. It typically develops suddenly, often in response to an infection like strep throat.
  • Pustular psoriasis. Pustular psoriasis is another example of how psoriasis symptoms can change with time. This type causes small, white pustules. It is rare, but often severe, and can affect the hands and feet or other parts of the body. A flare of pustular psoriasis can precede plaque psoriasis symptoms, occur alongside plaque psoriasis symptoms, occur after a flare of plaque psoriasis, or occur on its own.
  • Nail psoriasis. Nail psoriasis is common among people who have psoriasis, and also among people that have psoriatic arthritis. It affects the nails of the fingers and toes, causing the nails to thicken, crumble, become pitted, and separate from the nail bed. Up to 35 percent of people with psoriasis—and up to 80 percent of people with psoriatic arthritis—experience these symptoms.
  • Erythrodermic psoriasis. Only about 3 percent of people with psoriasis experience erythrodermic psoriasis, a life-threatening form of the disease that causes inflammation across most of the body and the rapid loss of large areas of skin. Complications can be life-threatening. It usually occurs in people with severe and uncontrolled psoriasis, and often in response to a trigger, such as medication withdrawal, an allergic reaction to a medication, an infection, or an injury like sunburn.

Remember that psoriasis is unpredictable, and these symptoms can vary from person to person.

Other skin conditions
It is important to note that a new symptom may not necessarily be psoriasis. There are many conditions that affect the skin—eczema, fungal infections, seborrheic dermatitis—and having one does not exclude having another.

It is important to talk to your healthcare provider about all of your symptoms and any new symptoms that you are experiencing. Different types of psoriasis may require different approaches to treatment, and skin conditions that are not psoriasis will require different treatments.

As mentioned above, psoriasis varies from person to person and is often unpredictable. Your best source of information about your health and your skin is your healthcare provider.

Medically reviewed in June 2020.

Sources:
National Psoriasis Foundation. "Plaque Psoriasis."
UpToDate. "Patient education: Psoriasis (Beyond the Basics)."
National Psoriasis Foundation. "Inverse Psoriasis."
Giuseppe Micali, Anna Elisa Verzi, et al. “Inverse Psoriasis: From Diagnosis to Current Treatment Options.” Clinical, Cosmetic and Investigational Dermatology, 2019. Vol. 12.
Medical News Today. "Inverse psoriasis: What you need to know."
National Psoriasis Foundation. "About Psoriasis."
MedlinePlus. "Guttate psoriasis."
Dahlia Saleh and Laura S. Tanner. "Psoriasis, Guttate." NCBI StatPearls. Updated Oct. 2018.
Huma A. Mirza and Talel Badri. "Generalized Pustular Psoriasis." NCBI StatPearls. Updated Jan. 2019.
National Psoriasis Foundation. "Hands, feet and nails."
National Psoriasis Foundation. "Erythrodermic Psoriasis."
American Academy of Dermatology. "How Long Will I Have To Treat My Psoriasis?"
H. C. Williams and D. P. Strachan. "Psoriasis and Eczema Are Not Mutually Exclusive Diseases." Dermatology, 1994. Vol. 189, No. 3.
Medical News Today. "Is there a link between psoriasis and Candida?"
Medical News Today. "How do psoriasis and seborrheic dermatitis differ?"

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