What are the different forms of psoriasis?

The appearance, location, and severity of psoriasis depend on which kind you have. Plaque psoriasis is the most common, accounting for 80% of cases in adults (it's primarily an adult disease). The four other main types -- guttate, pustular, inverse, and erythrodermic -- are much less common. Here's a quick guide:
  1. Plaque psoriasis causes raised red patches that typically shed flakes or scales of dead skin. Typically, it affects the outside of the elbows and knees, the back, and the scalp. The patches are usually symmetrical, affecting left and right sides of the body in the same location. They can be 1/2 inch to over 4 inches in diameter. Not surprisingly, the skin can become dry, cracked, and painful.
  2. Inverse psoriasis affects places where the skin folds against itself, such as the joints, armpits, groin area, under the breasts, and between rolls of fat (it may be more common in people who are overweight). It is called inverse because it tends to be inside the elbows and knees, unlike plaque psoriasis, which occurs on the outside of joints.
  3. Guttate ("drop-like") psoriasis often appears suddenly as many small (less than 1/2 inch) red "drops" on the skin. It doesn't always become as thick or scaly as plaque psoriasis, and it often clears up after a few weeks or months. This kind of psoriasis tends to affect the trunk and may be triggered by a bacterial infection (such as strep throat) during childhood or early adulthood.
  4. Pustular psoriasis is relatively rare. This is a good thing because one form of it, known as generalized or von Zumbusch pustular psoriasis, covers large areas with tender red skin and blisters, and it can be life threatening. Another form, localized or palmar-plantar psoriasis, forms blisters over small areas (such as the hands and feet). It's strongly associated with smoking.
  5. Erythrodermic psoriasis is very rare and painful. It spreads widely and makes skin look and feel burned and fiery. It's a serious condition and needs medical treatment immediately, frequently in a hospital.

Dr. Michael Roizen, MD
Internal Medicine

There are as many kinds of psoriasis as there are days in the school week. The most common is plaque psoriasis, which occurs in roughly 80% of psoriasis cases. Plaque psoriasis is characterized by red, itchy, raised skin with white or silver patches of dead skin, referred to as scales (don’t worry, it doesn’t mean you’re turning into a fish). Other forms include:

• guttate psoriasis (small dot-like lesions; usually appears after a sore throat or other sickness)

• pustular psoriasis (lesions that leak pus or other fluid like a drippy faucet, and have a lot of scales; usually appears on soles of feet and palms of hands, but can develop anywhere)

• inverse psoriasis (severely inflamed lesions in skin folds, like armpits, under breasts, and the groin area)

• erythrodermic psoriasis (intense redness that looks like a burn, along with shedding of scales; usually the least common of all types of psoriasis, and may be serious enough to be life-threatening)

Be aware, though: Psoriasis is often confused with atopic dermatitis, a form of eczema. Your doctor can best determine which form you have, or whether it is in fact atopic dermatitis and how your symptoms should be treated.



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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.