Types of psoriasis

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There are several types of psoriases, examples include:

• Plaque psoriasis (psoriasis vulgaris) - about 80% to 90% of people with psoriasis have this type. Signs and symptoms include raised areas of inflamed skin covered with silvery white scaly skin (plaques). A flaky white build up of dead skin cells accumulates on the plaques; this is called scale.
  
  Plaque psoriasis can appear on any skin surface. Most commonly affected areas are the knees, scalp, trunk, nails and elbows. This scale becomes dislodged and sheds from the plaques. Affected areas of skin are usually extremely dry, itchy. Sometimes there is pain and cracking of the skin. Psoriasis vulgaris means “common psoriasis”.
• Flexural psoriasis (inverse psoriasis) - psoriasis occurs in skin folds (flexion creases), especially in the armpits, genitals, pannus (under the stomach of an overweight person), under the breasts (inframammary fold) and buttocks. The affected areas appear as smooth, dry areas of skin that are inflamed and red. However, they do not have the scaling which is common with plaque psoriasis. This type of psoriasis is more common in overweight/obese individuals - people who have more skin folds; skin folds which are susceptible to irritation from sweating and rubbing. Individuals with flexural psoriasis are susceptible to fungal infections.
• Guttate psoriasis - characterized by red, scaly patches of inflamed skin all over the body, especially the trunk, limbs and scalp. It is often linked to streptococcal throat infection.
• Pustular psoriasis - appears as pustules (non-infectious pus filled raised bumps). The skin surrounding and under the pustules is tender and red. This type of psoriasis can be localized, for example to the feet and hands (palmoplantar pustulosis), or generalized in which patches occur randomly on any part of the body.
  
  Psoriatic arthritis - includes inflammation of the skin (psoriasis) and the joints and connective tissue (arthritis). Any joint may be affected, but most commonly the finger and toe joints, resulting in dactylitis (sausage-shaped swelling of the fingers/toes). The hips and knees may also be affected. Some patients develop spondylitis (the spine is affected). According to the National Psoriasis Foundation, USA, approximately 10% to 30% of people with psoriasis suffer from this type of psoriasis.
  
  Treatment of psoriatic arthritis is similar to that of rheumatoid arthritis. This type of psoriasis tends to develop about 10 years after the first signs and symptoms of psoriasis. Most people develop psoriatic arthritis between the ages of 30 and 50 years, but it can affect people of any age, including children. In a minority of cases arthritis symptoms may occur before skin symptoms.
  
  Click here for a more comprehensive article about Psoriatic Arthritis.
  
  
• Erythrodermic psoriasis - the rarest form of psoriasis. An especially inflammatory psoriasis, involving widespread inflammation and exfoliation (shedding) of the skin (over most of the body’s surface). This type of psoriasis appears most commonly on individuals who have unstable plaque psoriasis, where lesions are not clearly defined. It may develop after abrupt withdrawal of systemic treatment (treatment that reaches all parts of the body through the bloodstream). It is characterized by intermittent, widespread fiery redness of the skin. During exfoliation and reddening of the skin the patient may experience severe itching and pain; and also swelling.
  
  As this form of psoriasis undermines the body’s ability to regulate temperature, as well as the skin’s barrier functions, it can be fatal.
• Nail psoriasis - there is discoloring under the nail plate that resembles a drop of oil beneath it, pitting of the nails, lines seen across the nails, and thickening of the skin under the nail. The nail thickens at the tip, with ridges and pits. The nail may also loosen and crumble (onycholysis). This type of psoriasis is common among patients suffering from psoriasis - reported incidences vary from 10% to 78%. It is more common among individuals who have psoriatic arthritis, as well as elderly patients.