Symptoms of Psoriasis

Symptoms of Psoriasis

The onset of psoriasis, also known as psoriatic disease, is often accompanied by a range of symptoms. The primary indicators of this condition include the appearance of dry, thick, and raised patches on the skin, typically covered with white to silvery scales that may cause itching. Other symptoms can vary depending on the type of psoriasis, as well as the location and extent of the affected area. Below, we outline these symptoms based on the specific types of psoriasis:

• Plaque Psoriasis (Plaque psoriasis) is the most common form, accounting for approximately 80-90% of psoriasis cases, according to the American Academy of Dermatology. This variant is characterized by distinct thick red patches that are occasionally topped with dry, white, silver-tinged scales. The size of these patches can vary significantly, and smaller plaques may merge to form larger areas. Common sites for these plaques include the scalp, elbows, knees, and lower back, although they can appear anywhere on the body.
• Guttate Psoriasis (Guttate psoriasis) presents suddenly with small, scaly, pinkish spots primarily appearing on the arms, legs, and trunk, and may also affect the face, scalp, and ears. This type is often associated with infections like strep throat and is most prevalent among children and young adults. Fortunately, guttate psoriasis is typically temporary, with symptoms resolving spontaneously within weeks or months or after the underlying infection has been treated. However, in some cases, symptoms can persist for a lifetime.
• Inverse Psoriasis (Inverse psoriasis), also referred to as intertriginous psoriasis, appears as smooth, shiny patches that may at times have a slight white to silver sheen. These lesions occur in skin folds such as the armpits, groin, buttocks, and under the breasts. This type can lead to cracks in the affected skin that may result in pain and bleeding, and given the sensitivity of these locations, it is prone to bacterial or fungal infections and irritation due to excessive scratching and sweating.
• Pustular Psoriasis (Pustular psoriasis) is considered a rare form of the disease, with studies indicating a strong correlation between smoking and this type. Patients may experience widespread red patches that rapidly develop into pus-filled blisters. These lesions can dry out, leaving brown patches on the skin. While these pustules typically disappear within a few days, they can recur in some individuals, causing significant pain. In rare cases, pustular psoriasis may lead to additional systemic symptoms, such as fever, headache, and muscle weakness, and is more commonly found in adults than in children, often recurred across family members.
• Erythrodermic Psoriasis (Erythrodermic psoriasis) is an uncommon yet severe type, capable of altering the body’s chemistry. Symptoms may develop suddenly or gradually and include:
  • Widespread redness across most skin areas accompanied by severe itching and pain.
  • Large patches of peeling skin.
  • Presence of pustules.
  • Skin appearance akin to severe burns.
  • Increased heart rate.
  • Fluctuations in body temperature.
  • Swelling of the skin, especially around the ankles, with joint pain.
• Nail Psoriasis (Nail psoriasis) affects nails in many cases due to other forms of psoriasis (35%) or psoriatic arthritis (86%), according to research from the National Psoriasis Foundation. Symptoms include:
  • Holes in the nails.
  • Deformed nail shape.
  • Thickening of the nails.
  • Discoloration of the nails, which may appear brownish or yellow, resembling a fungal infection.
  • Nail separation from the nail bed.
• Scalp Psoriasis (Scalp psoriasis) can affect the entire scalp or limited areas and may extend to the ears, neck, and forehead. Mild cases show small, scaly patches, while severe forms are marked by dry, flaky skin along with red blistering and a burning sensation. In some instances, hair loss can occur in affected areas, although this tends to be temporary, often accompanied by intense itching leading to bleeding and infection.
• Psoriatic Arthritis (Psoriatic Arthritis) is a type of inflammatory arthritis that may affect individuals with psoriasis. It manifests in two forms: mild, involving four or fewer joints, and polyarticular, impacting four or more joints. Common symptoms include swelling of the fingers and toes, pain in the hands and feet, and lower back discomfort, potentially leading to a condition called spondylitis, which involves inflammation of the joints between the vertebrae and may extend to the joints between the spine and pelvis (sacroiliitis).

For further information on the different types of psoriasis, please refer to the following article: Types of Psoriasis.

Symptoms of Psoriasis During Pregnancy

Generally, psoriasis does not affect a woman’s ability to conceive or deliver. Nonetheless, it is essential to inform a healthcare provider about psoriasis before planning a pregnancy to ensure comprehensive healthcare during this period. It is also advised to avoid psoriasis triggers as much as possible to minimize flare-ups. Some women observe a notable improvement in psoriasis symptoms throughout their pregnancy, while others may experience a worsening of symptoms, and some report no changes at all. A study published in JAMA Dermatology in 2005 indicated that around 55% of women experienced symptom relief during pregnancy, with 23% reporting worsening symptoms, while 21% experienced no change. Therefore, predicting the course of psoriasis during pregnancy can be challenging.

Additionally, a rare form of psoriasis known as pustular psoriasis of pregnancy (PPP) may appear during this time, typically emerging in the early third trimester. This condition is characterized by inflamed skin areas, particularly in skin folds such as the armpits, thighs, and under the breasts, along with the formation of blisters. These cannot affect the face, soles of the feet, or palms. This condition is more likely to appear in mothers with a history of psoriasis or a family history of the disease but can also occur in those without prior experience. Symptoms such as diarrhea, confusion, fever, and fatigue may accompany PPP. It is crucial for women suffering from this type of psoriasis to receive appropriate treatment promptly to safeguard both maternal and fetal health.

Tips for Alleviating Psoriasis Symptoms

Here are several daily precautions that patients may consider to alleviate psoriasis symptoms and promote healing:

• Maintain skin moisture to reduce itching, redness, and dryness by applying a suitable moisturizer. Different formulations are available, and the choice should depend on the dryness of the skin. It is advisable to use ointments after bathing to help seal in moisture. Moisturizers should be fragrance-free and should be applied multiple times a day, particularly during cold or dry days.
• Get moderate sun exposure, approximately 2-3 times a week, after consulting with a physician. Excessive sun exposure may worsen psoriasis symptoms and increase the risk of skin cancer. It’s essential to use sunblock for unblemished skin.
• Shower daily in warm water to help eliminate dead skin and scales, as well as reduce itching and inflammation. Use a gentle soap and avoid hot water. It’s recommended to soak in the tub for 10-15 minutes, patting the skin dry instead of rubbing, and generously applying moisturizer immediately after bathing to lessen itchiness.
• Quit smoking and abstain from alcohol consumption.