- Beyond the skin
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.
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.
It mainly affects genitals and body folds (e.g. armpits, inframammary creases, groins, gluteal cleft).
Characterised by reddish, drop-like papules and plaques, mainly involving the trunk, arms, and legs.
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).
Characterised by fiery redness and exfoliation of most of the body surface, it can lead to hypothermia and cardiac failure.
Although psoriasis and eczema may present similar symptoms, there are clear differentiating factors that help you identify them.
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]
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]
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.
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 has a deep impact on patients' physical and mental health.
Different treatments address different needs.