Psoriasis

Signs and Symptoms of Psoriasis

Psoriasis isn’t just a skin issue; it’s an autoimmune condition. In simple terms, this means your immune system mistakenly attacks healthy cells, particularly those of the skin in psoriasis. This results in the rapid buildup of skin cells, leading to the itchy or painful patches and other symptoms commonly associated with psoriasis. Understanding that psoriasis is an autoimmune condition that can affect your entire body and quality of life will help demystify why it happens and how it affects your skin — and potentially other parts of your body. (Source)

Diagnosing psoriasis early can make a world of difference in living with the condition. Why? Because timely diagnosis can lead to effective management, reducing the severity of symptoms and improving your overall well-being. The sooner you identify the signs and symptoms, the quicker you can consult health care professionals for a diagnosis and treatment plan tailored to your needs. (Source)

At WellTheory, we’re on a mission to empower and support you on your recovery from psoriasis. Whether you’re new to understanding this autoimmune condition or have been navigating this journey for a while, this guide aims to provide comprehensive, evidence-based information. We’ll delve into the signs and symptoms of psoriasis, drawing from the latest medical research to help you recognize early signs, understand the range of symptoms, and seek timely medical advice.

So, let’s dive in, shall we?

Getting to Know Your Type of Psoriasis

Understanding the specific type of psoriasis you’re dealing with is the first step toward reclaiming your well-being. Psoriasis comes in various forms, each with its own set of symptoms and care options. The more you know about your type, the better equipped you’ll be to manage it effectively. So, let’s explore the different forms of psoriasis to help you prepare for seeking proper care.

Plaque Psoriasis

Plaque psoriasis is the most common form, affecting up to 80% of people with the condition. This form typically begins as small, red bumps that merge together to form round or oval red patches with well-defined edges, called plaques. These plaques are often covered with a silvery-white coating called scale. You’ll most likely find them on your scalp, elbows, knees, or lower back. (Source)

Signs & Symptoms

  • Plaques tend to remain static or slowly enlarge.
  • Silvery scales on the patches look similar to dandruff.
  • You may have itching and pain.
  • Plaques may be surrounded by a white ring, known as Woronoff’s ring.
  • Areas of the body commonly affected include the elbows, knees, and scalp.

Common Triggers

  • Emotional stress is a well-known trigger. 
  • Cuts, scrapes, or even excessive scratching can cause new psoriatic patches to appear on the injured skin, known as the Koebner phenomenon.
  • Beta-blockers, antimalarial drugs, and lithium are some medications known to trigger plaque psoriasis.

Guttate Psoriasis

Guttate psoriasis is a form of psoriasis that predominantly affects children and young adults. Unlike the more common chronic plaque psoriasis, this type manifests as small, droplet-like red spots rather than larger, scaly patches. The name “guttate” is derived from the Latin word gutta, which means “drop,” reflecting the droplet-like appearance of the lesions.

These tiny, salmon-colored bumps are about the size of a water droplet and can range from 2 mm to 10 mm across. You might have just a few spots or more than a hundred spreading out in a pattern that moves away from the center of the body. The bumps are small and scaly and often clear up in a few weeks or months without treatment. (Source)

Signs & Symptoms

  • Small, dot-like lesions or spots are less thick and scaly compared to other psoriasis types.
  • While less noticeable, they can still be a concern.
  • They are generally less itchy but may cause some discomfort.
  • They mostly appear on the shoulders, chest, lower abdomen, back, buttocks, and limbs.

Common Triggers

  • It is often triggered by a streptococcal infection, such as strep throat. 
  • Stressful life events can lead to an outbreak.

Inverse Psoriasis

Inverse psoriasis is a unique form of psoriasis that primarily affects the skin folds, such as the armpits, under the breasts, and around the groin and buttocks. Unlike other types of psoriasis that produce a dry, scaly surface, inverse psoriasis manifests as smooth, bright red plaques. These plaques are often hidden and may not be immediately visible because of the parts of the body that are usually affected. (Source)

Signs & Symptoms

  • There is little or no silvery-white coating.
  • Bright red, often smooth and shiny, plaques develop in skin folds. 
  • Plaques may become fissured or cracked, increasing the risk of secondary bacterial or fungal infections.
  • Unlike other forms of psoriasis, this type is almost exclusively found in skin folds, making it easier to identify.

Common Triggers

  • The rubbing of skin against skin in these folded areas can exacerbate the condition. 
  • Sweat and moisture can further irritate the affected areas.
  • Increased presence of skin folds due to overweight and obesity provides more sites for plaques to form.

Generalized Pustular Psoriasis

Also known as von Zumbusch psoriasis, this is a rare and severe form of psoriasis. It is characterized by inflamed, red, and tender skin that is soon followed by the emergence of tiny pus-filled bumps or pustules. These pustules can be widespread, affecting large areas of the body.

This type is less common but more severe. It’s characterized by pus-filled bumps that appear on the hands and feet. The skin around these bumps is red and swollen, and it can be extremely painful. (Source)

Signs & Symptoms

  • Onset involves initial redness and tenderness of the skin.
  • This is followed by the rapid appearance of tiny pus-filled bumps (pustules).
  • The skin around the pustules is red and inflamed.
  • Pustules are uncomfortable, or even painful.

Common Triggers

  • abrupt withdrawal from corticosteroids
  • use of irritating topical treatments

Localized Pustular Psoriasis 

Localized pustular psoriasis targets specific areas of your body, such as your fingers, toes, palms, and soles. Unlike other forms, it manifests as clusters of yellow pustules that are sterile, meaning they don’t contain bacteria. These pustules are set against a backdrop of inflamed, red, and scaly skin, making the condition both uncomfortable and potentially distressing. (Source)

Signs & Symptoms

  • yellow pustules on fingers, toes, palms, and soles
  • red, scaly skin around pustules

Common Triggers

  • physical trauma to affected areas
  • smoking
  • humidity and high temperature

Erythrodermic Psoriasis

Erythrodermic psoriasis is a severe and less common form of psoriasis that can be life-altering. It affects almost the entire skin surface, leading to widespread redness and shedding of the skin. The condition is often accompanied by intense itching and pain, making it both physically and emotionally distressing. Due to its severity, it may require immediate medical intervention and can lead to complications such as dehydration and temperature regulation issues. (Source)

Signs & Symptoms

  • fiery redness over large areas of the body
  • severe itching and pain
  • chills and fever
  • muscle weakness and rapid pulse

Common Triggers

  • specific types of infections, such as streptococcal or staphylococcal infections
  • sudden withdrawal from corticosteroid medications
  • high blood pressure medications such as beta-blockers 

(Source)

Nail Psoriasis

This predominantly affects the nails of both fingers and toes. It not only affects the appearance of the nails but also the ability to use the hands or feet effectively. Nail psoriasis can occur even if you don’t have skin plaques and is often a predictor of psoriatic arthritis. It’s not just a cosmetic issue, but a sign of systemic inflammation that requires attention. (Source)

Signs & Symptoms

  • Nail pitting, which involves small dents or depressions on the nail surface, can vary in size and depth.
  • Psoriasis affecting the nail bed causes discolored nails, often yellow or brown in color. 
  • Nails become thicker, making you more susceptible to fungal infections that may cause discomfort.

Common Triggers

  • If you have psoriatic arthritis, you’re more likely to experience nail changes. The inflammation affecting your joints often extends to the nails, making this a common trigger.
  • Those with psoriasis affecting the scalp often find their nails are also affected. The same inflammatory processes that cause skin plaques can affect the nails.

Palmoplantar Psoriasis

Palmoplantar psoriasis specifically targets the palms of the hands and the soles of the feet. This form of psoriasis can be particularly debilitating, as these areas are essential for many daily activities such as walking, holding, and grabbing. (Source)

Signs & Symptoms

The most distinguishing feature is the presence of thick, often painful scales on the palms and soles. These scales can crack and bleed, causing further discomfort.

Common Triggers

The triggers for palmoplantar psoriasis are not well-understood, making it challenging to predict and prevent flare-ups. However, stress and certain medications have been implicated in some cases. 

Psoriatic Arthritis 

Psoriatic arthritis is a form of arthritis that affects some people who have psoriasis. This condition can range from mild to severe and affects both the skin and the musculoskeletal system. (Source)

Signs & Symptoms

  • joint pain
  • changes in the color of the nails, similar to psoriatic nail disease
  • a swollen and tender joint, especially in a finger or toe
  • swelling and pain on the back of your leg, just above your heel
  • stiffness in the morning that fades during the day
  • In severe cases, the bones may fuse together, known as bone ankylosis, severely limiting mobility.

(Source, Source)

Common Triggers

The exact triggers for psoriatic arthritis are not fully understood, but genetic factors, environmental triggers, and immune system dysfunction are thought to play roles. (Source)

Impetigo Herpetiformis

Impetigo herpetiformis is a rare form of psoriasis that occurs during pregnancy. This condition is not only distressing for the expectant mother but also poses risks for the unborn child. (Source)

Signs & Symptoms

  • Presents as tiny pus-filled bumps, usually on the inside of the elbows or behind the knees.
  • Bumps may emit a foul odor, adding to the discomfort.

Common Triggers

Hypocalcemia, which refers to low levels of calcium in the blood, is also often associated with this form of psoriasis. (Source)

Clearing the Air: Debunking Common Myths About Psoriasis

When it comes to psoriasis, misinformation can be as rampant as the condition itself. Let’s set the record straight by debunking some common myths about psoriasis.

Myth 1: Psoriasis Is Just a Skin Condition

The Truth: It’s an Autoimmune Disease

Contrary to popular belief, psoriasis isn’t just about the skin; it’s an autoimmune condition. Your immune system mistakenly targets healthy skin cells, leading to the symptoms you see. (Source)

Myth 2: Psoriasis Is Contagious

The Truth: You Can’t Catch It From Someone Else

Many people avoid physical contact with those who have psoriasis, thinking it’s contagious. This is far from the truth. Psoriasis is caused by an immune response, not a virus or bacteria you can catch. (Source)

Myth 3: Psoriasis Is the Result of Poor Hygiene

The Truth: Hygiene Has Nothing to Do With It

Some people mistakenly think that psoriasis is due to poor hygiene. This is not only incorrect but also stigmatizing. Psoriasis is an autoimmune condition, and its occurrence is not related to cleanliness. (Source)

Myth 4: Diet Doesn’t Affect Psoriasis

The Truth: Diet Can Play a Role

While diet alone can’t cause or cure psoriasis, certain foods can trigger flare-ups or help manage symptoms. It’s always a good idea to consult with health care providers for personalized advice. (Source)

Myth 5: Children Don’t Get Psoriasis

The Truth: Kids Can Get It Too

Psoriasis can occur at any age, including during childhood. In fact, symptoms often first appear between the ages of 15 and 25. (Source)

Practical Tips for Telling Whether or Not You Have Psoriasis

Here are some practical tips that can help you identify symptoms and seek timely medical advice.

How Do I Know It’s Psoriasis and Not Just Dry Skin?

  • Check for red patches: Psoriasis often starts as red, inflamed patches of skin. If you notice these, especially if they’re not going away, it’s time to consult a health care provider.
  • Look for symmetry: Psoriasis patches often appear on both sides of the body. If you have a patch on one elbow, check the other.
  • Examine the edges: Psoriasis patches usually have well-defined edges, unlike eczema or simple dry skin.

What Are These Scales on My Skin?

  • Check for silvery scales: One of the hallmark symptoms of plaque psoriasis is the development of silvery, scaly layers over the red patches.
  • Look for the “wax spot” phenomenon: If the scales fall off like layers of candle wax when scraped, it’s a sign you might be dealing with psoriasis.

Why Does It Itch So Much?

  • itching and discomfort: Psoriasis can be itchy and even painful. Researchers believe the inflammatory molecules present in psoriatic plaques interact with nerve endings on the skin, sending signals to the brain saying that you’re itchy. If you’re experiencing persistent itching, especially on patches of red skin, it’s a sign to consult a health care provider. (Source)

Are There Any Other Signs?

  • nail changes: Pitting, discoloration, and thickening of the nails can be a sign of psoriatic nail disease, often associated with psoriasis.
  • emotional stress: Stress can be both a trigger and a symptom. Consider it a red flag if you're feeling unusually stressed and notice skin changes.
  • painful joints: Psoriatic arthritis can cause joint pain. If you’re experiencing this alongside skin symptoms, getting a diagnosis as soon as possible is crucial.

Where Should I Look?

  1. Look at commonly affected areas: Psoriasis often appears on the elbows, knees, scalp, and lower back. But don’t ignore other areas such as the palms, soles, or even the genital area.
  2. Check skin folds: Inverse psoriasis appears in skin folds such as under the breasts, armpits, or around the groin and buttocks.

How WellTheory Can Help: Your Partner in Managing Psoriasis

Navigating the complexities of psoriasis can feel overwhelming, but you don’t have to go it alone. At WellTheory, we specialize in evidence-based, whole-body, and data-driven strategies to manage autoimmune conditions like psoriasis. Here’s how we can be your partner in this journey:

  • personalized care plans: We understand that psoriasis is not a one-size-fits-all condition. Our care team crafts personalized plans focusing on your unique symptoms and lifestyle needs.
  • personalized nutritional guidance: One of the cornerstones of managing psoriasis effectively is nutrition. We offer personalized dietary plans rooted in scientific research aimed at reducing inflammation and managing symptoms.
  • effective stress management techniques: Stress is a known trigger for psoriasis flare-ups. Our team provides you with practical stress management techniques, such as mindfulness and deep breathing exercises, to help you keep stress at bay.
  • sleep hygiene: Quality sleep is crucial for overall well-being and can significantly affect the severity of psoriasis symptoms. We offer sleep hygiene advice to ensure you get the restorative sleep you need.
  • ongoing support and monitoring: Managing psoriasis is a long-term commitment. We offer continuous care and monitoring to adapt your treatment plan as your needs change, ensuring you always have the support you need.
  • emotional and psychological support: We know psoriasis can affect your emotional well-being. Our care team, with firsthand autoimmune experiences, offers empathetic and continuous emotional support.
  • a community of support: Join a community of individuals who are also navigating the challenges of psoriasis. Share experiences, learn from others, and find comfort in knowing you're not alone.

The Bottom Line

Psoriasis is more than skin deep; it’s a complex autoimmune condition that can significantly affect your quality of life. But with the right information and support, psoriasis is entirely manageable. Whether you’re newly diagnosed or have been managing psoriasis for years, WellTheory is here with you at every step of your healing journey.

References

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Voloshyna, D., Ullah S. E., Jahan, N., Yadlapalli, S. S., Zahoor, M. M., Shams, Y., Sathish, M., Sandhu, Q. I., Saleem, F. (2022). Beta-blocker-induced erythrodermic psoriasis: A case report. Cureus, 14(10), e29809. https://doi.org/10.7759/cureus.29809