Not every type of psoriasis is the same
Not every type of
psoriasis is the same
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In your day-to-day practice, you may encounter various types of psoriasis.[1] Identifying them can make a difference to your patients’ management of psoriasis.
Plaque psoriasis (~58% to 97% of all psoriasis cases)[1][2]
- Also called ‘vulgaris psoriasis’, it is the most common type of psoriasis.
Characterised by inflammatory red, sharply demarcated, raised, dry, differently sized plaques, usually covered by silvery or white scales.
It mainly involves the scalp and the area behind the ears, elbows and knees, as well as the trunk, face, palms, soles of the feet and nails.
Intertriginous psoriasis (~12% to 26% of all psoriasis cases)[1][3][4]
- Characterised by deep-red or white, flat, sharply demarcated, wet patches or plaques. Scales are usually absent.
It mainly affects genitals and body folds (e.g. armpits, inframammary creases, groins, gluteal cleft).
Guttate psoriasis (~0.6% to 20% of all psoriasis cases)[1][2][5]
- Also called ‘droplet psoriasis’, it usually occurs in childhood and adolescence.
Characterised by reddish, drop-like papules and plaques, mainly involving the trunk, arms, and legs.
Pustular psoriasis (~1% to 12% of all psoriasis cases)[1][2][3]
- Characterised by coalescing pustules filled with non-infectious pus.
It can involve either small areas such as palms of the hands, fingertips, nails, and soles of the feet, or the entire surface of the body (as a single episode after a trigger).
Erythrodermic psoriasis (~0.4% to 7% of all psoriasis cases)[1][2][3]
- Although rare, it is the most serious and potentially life-threatening type of psoriasis.
Characterised by fiery redness and exfoliation of most of the body surface, it can lead to hypothermia and cardiac failure.
Although most patients present with only a single type of psoriasis at one time, some may develop two different types simultaneously[6]
Psoriasis and eczema are different
Although psoriasis and eczema may present similar symptoms, there are clear differentiating factors that help you identify them.
- Eczema usually presents as thin patches of dry red or brown skin.
Lesions are bumpy, and the borders between affected and unaffected skin are usually not well-defined.
However, when dyshidrotic, eczema presents with a well-demarcated plaque with vesicles on palms and soles of the feet.
If the rash worsens after beginning the treatment for suspected eczema, the patient probably has psoriasis.[7] Moreover, a patient can have multiple skin conditions at once.[7]
- Plaque psoriasis typically presents as red plaques with silvery scales (on lighter skin) or as purple or discolored skin (on darker skin).
Plaques may be thick, raised, cover a large area of skin, and usually have very defined borders.
However, pustular psoriasis may present with erythema and pustules on palms or soles
After beginning the treatment for suspected eczema, if rash worsens, the patient probably has psoriasis.[7] Moreover, a patient can have different skin conditions at once.[7]
Assess the severity of psoriasis
You can assess disease severity by looking at the degree of redness, thickness, and scaling of skin lesions,[8] as well as the Body Surface Area (BSA) of the disease.[9]
Please note that psoriasis skin lesions may appear differently on darker skin.
The percentage of BSA is an indicator of psoriasis severity:
BSA is the proportion of a patient’s body affected by psoriasis — one hand is roughly 1% of a patient’s BSA[9][10]
Psoriasis can be considered severe irrespective of BSA when it has serious emotional or quality of life consequences[9]
Discover more
Psoriasis has a deep impact on patients' physical and mental health.
Different treatments address different needs.
