Not every type of psoriasis is the same

Not every type of
psoriasis is the same

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.

  • 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.

  • 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).

  • 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.

  • 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).

  • 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]

A psoriasis severity checker tool, specially for your patients.

Discover more

Beyond the skin

Psoriasis has a deep impact on patients' physical and mental health.

Manage psoriasis

Different treatments address different needs.