There are 5 types of psoriasis. Each type of psoriasis has its own unique symptoms. These unique symptoms will help the doctor determine which type of psoriasis is present. Different types may be present at the same time.

Psoriasis Copyright © Nucleus Medical Media, Inc.

The following is a brief outline of each type of psoriasis and a description of the accompanying signs and symptoms.

Plaque Psoriasis

Plaque psoriasis is the most common form. It is named for the “plaques,” or lesions, that are characteristic of this type of psoriasis. Plaques tend to be stable and slow growing, and they may remain unchanged for long periods of time.

Signs and symptoms include:

• Red, raised skin patches (plaques) topped by silvery-white scales
• Frequent shedding of silvery scales
• Outbreaks most frequent on the elbows, knees, scalp, buttocks, and lower back
• Patches often occur in the same area on both sides of the body
• Patches may join together to form large affected areas on the back and chest
• May involve anywhere from a few areas to almost covering the entire body surface
• Occasional discomfort and cracking in the affected areas, especially palms, fingers, and soles
• Patches may be itchy

Nail findings may include:

• Pitting
• Onycholysis—nail detachment
• Subungual hyperkeratosis—buildup underneath the nail
• Oil-drop sign—yellow-red discoloration of the nail bed

Guttate Psoriasis

Guttate psoriasis may appear after bacterial infections, such as streptococcus ( strep throat) or viral infections.

Signs and symptoms include small, salmon pink, drop-like lesions, usually on the trunk and limbs. May also be on scalp, face, and ears.

Inverse Psoriasis

Most commonly found in skin fold areas of the body, such as the armpits, groin, under the breasts, and genital areas. This type of psoriasis is also known as flexural psoriasis.

Signs and symptoms include:

• Smooth, pink or red, mostly dry patches without a scaly surface
• Rash may be painful and get worse with friction and sweating

Erythrodermic Psoriasis

This is the least common form of the disease. It can be triggered by severe sunburn, use of certain drugs, or abrupt withdrawal of oral steroids.

Signs and symptoms include:

• Widespread, fiery redness of the skin
• Severe itching and discomfort in the affected areas
• Possible swelling of the affected areas
• May be associated with trouble maintaining body temperature and rapid heart rate

Erythrodermic psoriasis is an emergency and should be evaluated immediately

Pustular Psoriasis

This form of psoriasis may be triggered by medication, emotional stress, infections, abrupt withdrawal of systemic steroids, or exposure to certain chemicals. It is a more rare form of psoriasis.

Signs and symptoms include:

• Blisters containing noninfectious pus in large (generalized) or small (localized) areas of the body.
  • Localized: Blisters confined to local areas, usually the palms, fingers, and soles. Pustules appear in a studded pattern, turn brown, and then peel.
  • Generalized: Blisters spread over large portions of the body, dry, and then recur again in repeated cycles lasting several days.

• May also be associated with not feeling well, fever, chills, severe itching, rapid pulse, loss of appetite, and muscle weakness.