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Can You Have More Than One Type of Psoriasis?

Posted on March 31, 2021
Medically reviewed by
Ariel D. Teitel, M.D., M.B.A.
Article written by
Paz Etcheverry, Ph.D.

It is possible to have more than one type of psoriasis at the same time. And psoriasis may change into another type in the future, according to the American Academy of Dermatology. Having more than one type of psoriasis can add to the challenge of managing psoriasis. One MyPsoriasisTeam member vented, “Having more than one type of psoriasis is getting annoying.”

Here are the types of psoriasis that can occur together, how often they occur together, and the ways to reduce your risk of developing more than one type.

Different Types of Psoriasis

Psoriasis is an immune system disorder that causes the skin cells to regenerate at high rates. Although it is often referred to as a single condition, psoriasis is an umbrella term. There are several types of psoriasis, which have different symptoms and occur in different areas of the body.

Plaque psoriasis, or psoriasis vulgaris, accounts for up to 90 percent of all cases and is characterized by itchy, white scaly patches on red inflamed skin. It is the most common type.

Guttate psoriasis accounts for about 8 percent of psoriasis cases and causes small, teardrop-shaped red or purple dots on the limbs, torso, and stomach.

Erythrodermic psoriasis, which is the most severe type, affects 2 percent of people with psoriasis and causes nearly 80 percent of the body to be covered with bumps (papules) and plaques. Erythrodermic psoriasis covers large areas and may be life threatening.

Palmoplantar psoriasis, which affects the palms of the hands and soles of the feet with pinkish-yellow lesions, comprises 3 percent to 4 percent of all cases of psoriasis.

Psoriatic arthritis involves inflammation of the joints. It occurs in up to 30 percent of those with plaque psoriasis.

Inverse psoriasis has a prevalence of 3 percent to 36 percent in people with psoriasis. It causes smooth, shiny, itchy, red patches in areas where the skin rubs together, such as the armpits, under the breasts, and the groin. It is common to have other psoriasis outbreaks on parts of the body with inverse psoriasis.

Nail psoriasis causes pitting, detachment from the nail bed, and discoloration in the fingernails and toenails. About 50 percent of people with plaque psoriasis will also have psoriasis of the nails.

Pustular psoriasis accounts for about 1 percent of psoriasis cases and occurs when small, pus-filled bumps called pustules form on the skin. Generalized pustular psoriasis is a very rare skin condition that tends to affect young people. It may develop as a complication of plaque psoriasis. Localized pustular psoriasis appears on the hands and feet.

How Common Is It To Have More Than One Type?

Plaque psoriasis is usually the first type to develop in people who have more than one type of psoriasis. As many as 30 percent of those with plaque psoriasis may develop psoriatic arthritis. About 50 percent of people with plaque psoriasis will also have psoriasis of the nails, although it’s also possible for nail psoriasis to develop before skin psoriasis. Nearly 80 percent of people with psoriatic arthritis will develop nail psoriasis, as well. In people with pustular psoriasis, up to 40 percent may develop psoriatic arthritis.

Rates for other types of psoriasis are less defined. It’s possible to develop the risk factors for a second type of psoriasis — such as weight gain, strep throat infection, suddenly stopping psoriasis medication, or poor control of existing psoriasis — and consequently begin to show symptoms of the new type, as well.

Tips To Reduce the Risk

There is no sure way to know who will develop a second type of psoriasis. However, experts agree there seem to be several ways to reduce the risk, including:

  • Carefully managing your current psoriasis condition
  • Maintaining a healthy lifestyle and a healthy weight
  • Taking good care of your skin and avoiding sunburn
  • Consistently following your psoriasis treatment plan unless directed by your dermatologist

If you notice symptoms and suspect you may have developed an additional type of psoriasis or other skin disease, seek medical attention from a dermatologist or other medical professional. A dermatologist can help make a diagnosis and determine your best treatment options.

Talk With Others Who Understand

MyPsoriasisTeam is the social network for people with psoriasis and psoriatic arthritis and their loved ones. More than 90,000 members come together to ask questions, give advice, and share their stories with others who understand life with psoriasis and psoriatic arthritis.

Have you had multiple types of psoriasis? Share your experience in the comments below, or start a conversation by posting on MyPsoriasisTeam.

All updates must be accompanied by text or a picture.
Ariel D. Teitel, M.D., M.B.A. is the clinical associate professor of medicine at the NYU Langone Medical Center in New York. Review provided by VeriMed Healthcare Network. Learn more about him here.
Paz Etcheverry, Ph.D. has an M.S. in food science and nutrition from North Carolina State University and a Ph.D. in food science and technology from Cornell University. Learn more about her here.

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