When you hear the word “psoriasis,” you may think of inflamed patches of skin, but psoriasis can cause more than just a rash. The condition causes different symptoms depending on several factors, including what type of psoriasis you have. It’s also possible to have more than one type of psoriasis or for your psoriasis to change from one type to another.
Symptoms of psoriasis vary from person to person and can change over time. For most people with psoriasis, symptoms may decrease or disappear during periods of remission, only to reappear or worsen with disease flare-ups. Luckily, treating psoriasis with topical treatments (applied directly to the skin) or systemic therapies (medications that work throughout the entire body) can effectively help manage many of its symptoms.
Read on to learn about the different types of symptoms you may experience with psoriasis.
Skin symptoms will vary based on the type of psoriasis you have. Scalp psoriasis affects many people and appears as severe dandruff on the scalp with raised, discolored, and scaly plaques. These plaques are usually very itchy. Psoriasis can also affect the nails, which is commonly called nail psoriasis.
Keep reading to learn about the most common skin symptoms associated with each type of psoriasis.
Plaque psoriasis is the most common type of psoriasis, as it makes up 80 percent of psoriasis cases. It typically affects the elbows, knees, back, and scalp but may appear elsewhere. Common symptoms of plaque psoriasis include patches (or plaques) of thick, discolored, inflamed skin that can crack or bleed easily. Plaques are often covered with white or silver scales. Plaques cause intense itching, burning, and soreness. It’s important to know that plaques and other skin symptoms may vary with different skin colors. Plaques can appear brown, purple, or gray on darker skin and red or pink on lighter skin.
Learn more about plaque psoriasis.
In guttate psoriasis, patches of rash are small, scaly, and pink, red, brown, or purple (depending on your skin color). They have a round or oval shape. Guttate psoriasis can affect any part of the body except the palms of the hands and soles of the feet, but it’s commonly confined to the arms, legs, chest, and scalp. This form of psoriasis is often associated with having had an upper respiratory infection.
Inverse psoriasis causes smooth patches of skin that are usually painful. On lighter skin, they’re generally red in color. On darker skin, patches may be brown or purple-ish. Inverse psoriasis usually appears in areas where sweat and friction occur, such as the skin folds — in the armpits, genitals, and under the breasts. This form of psoriasis is often confused with fungal infections of the skin.
Pustular psoriasis — an uncommon form of the condition that is difficult to treat — causes discolored skin with sterile, pus-filled blisters, also called pustules or lesions. The subtypes of pustular psoriasis are classified based on the location and characteristics of pustules. For example, palmoplantar psoriasis causes pustules on the palms of the hands and soles of the feet, whereas von Zumbusch pustular psoriasis is considered generalized and causes pustules all over the body and systemic symptoms like fever and joint pain.
Erythrodermic psoriasis is the rarest type of psoriasis. It can affect the whole body, causing a rash that peels, itches, and burns. People with this form of psoriasis usually experience fever, chills, and dehydration and often require hospitalization.
Psoriasis and psoriatic arthritis (PsA) can affect fingernails and toenails in various ways. Nail psoriasis can cause the nails and nail beds to become thick and ridged, pitted, loose, or crumbly.
Nails may become discolored by spots of white, thin black lines, or a yellow-red appearance underneath. Some people with psoriasis develop inflammation or fungal infections in the nails due to the underlying nail dystrophy caused by psoriasis. Nail dystrophy refers to changes in the nails, like deformities or abnormalities in their structure, such as alterations in color, texture, thickness, or shape.
Fatigue is a very common symptom of psoriasis due to high levels of inflammation in the body. Around 30 percent of people with psoriasis also have psoriatic arthritis. PsA can be associated with anemia — low red blood cell count — which can also contribute to fatigue.
Depression and anxiety are common in people with psoriasis and psoriatic arthritis, as in many chronic diseases. Research has found that psoriasis can cause feelings of depression, and also that depression may cause psoriasis for some people. Depression includes symptoms like persistent sadness, low mood, loss of interest in activities or hobbies you once enjoyed, and difficulty concentrating.
Past research has found that people with psoriasis have a higher risk of anxiety as compared to people without psoriasis. Some symptoms of anxiety include restlessness, excessive worry, irritability, and fatigue.
Due to pain and itching, many people with psoriasis and psoriatic arthritis experience insomnia, or difficulty falling or staying asleep. Insomnia caused by pain is often referred to as “painsomnia.” As a result, feeling tired during the daytime is common for people with psoriasis and insomnia.
People with psoriasis may experience joint pain, which could indicate the presence of psoriatic arthritis. PsA typically causes stiffness, pain, and swelling in the joints and over the tendons.
If left untreated, psoriatic arthritis can cause joint damage that may lead to disability and severe joint deformity. In some people, PsA leads to ankylosing spondylitis — inflammation in the spine and hips that can cause the bones to fuse.
Psoriasis can affect your eyes. You may experience dry skin and scaling around your eyes and on your eyelids. People with psoriasis may experience dry eye syndrome and blepharitis, which causes inflammation, itching, and swelling of the eyelids.
Psoriasis and psoriatic arthritis can also cause uveitis (eye inflammation) that involves pain, redness, and light sensitivity in one or both eyes. About 7 percent of people with PsA develop uveitis. Left untreated, uveitis can progress and lead to loss of vision.
In the majority of cases, psoriasis begins either between ages 20 to 30 or between ages 50 to 60. However, psoriasis may develop in people of any age, even young children and infants.
Psoriasis symptoms may appear during a flare and diminish during a remission period. It’s a chronic condition that doesn't currently have a cure.
In most people, symptoms can be effectively treated with topical and systemic medications, light therapy, and lifestyle changes. Talk to your health care provider or a dermatologist about your symptoms and psoriasis treatment options that may help keep your symptoms under control.
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