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What are the Types of Psoriasis? Symptoms, Causes, Treatment, and Diagnosis

Psoriasis is an autoimmune disease which leads the skin cells to grow at a faster rate and build upon the surface. The symptoms of psoriasis can be seen as red, flakes and scaly patches appearing at any body part. The extra skin cell builds around can be itchy and painful. Psoriasis can take place at any part of the body depending upon the types of psoriasis and rashes tend to come and go in a while. Psoriasis is not contagious but chronic and affects around three percentiles of the population globally.

Types of Psoriasis

1. Plaque Psoriasis

This is the most common form of psoriasis. Around 80 to 90 percentile of people who have psoriasis, tend to be diagnosed with plaque psoriasis. It is characterised by raised, inflamed, red patches flaring around the body and covered with silvery- white scales. Plaque psoriasis usually takes place on the scalp, knee, lower back, and elbows. The most socially stigmatised is Face Psoriasis.

2. Inverse Psoriasis

Under inverse psoriasis, the lessons appeared are not dry and scaly. They appear to be smooth and shiny.  They commonly appear in the groin, buttocks, armpits and around the genital area. This psoriasis takes place in most sensitive areas. Hence any irritation makes the case worse.  Inverse psoriasis is most likely to be found in people who are overweight.

3. Nail Psoriasis

It is a type of plaque psoriasis that affects the region of toenails and fingernails. Nail psoriasis involves an oil- drop patches of salmon- shade, affecting the part of the nail that has been infected. Around 80 percentile of the population diagnosed with plaque psoriasis, shows some nail involvement, thereby infection of nail psoriasis.

4. Guttate Psoriasis

Many factors can give life to guttate psoriasis, such as stress, the problem in respiratory functions, tonsillitis or skin injury. The same can because by abuse of certain drugs like beta blockers or lithium. Guttate psoriasis can be characterised with tear-drops shaped, pink coloured, bumps, normally as thick as in plaque psoriasis. Guttate psoriasis commonly affects kids or people under the age of 30 years.

5. Erythrodermic Psoriasis

Erythema can be defined as reddening and as the name suggest, Erythrodermic psoriasis cause entire body to turn bright red. Under this psoriasis, a biopsy of skin is performed to distinguish it from other diseases. Erythrodermic psoriasis is severe and life-threatening. A person diagnosed with such disease will be required to hospitalised for making the conditions of the body stable.

6. Pustular Psoriasis

Pustular psoriasis can be characterised by white pustulas, non- contagious fluid covered around by the red skin.  It is non-infectious and non- contagious psoriasis, which is generally found in adults as compared to kids.  It is concentrated on the small areas of the body, except for the case of von zumbusch psoriasis, under which the whole body is affected. Such a condition is severe, and medical attention shall be required immediately.  The common symptoms of pustular psoriasis include fever, alleviated heart rates, chills, and dehydration.

Symptoms of Psoriasis

As seen above, psoriasis can be divided into numerous types, and it is nearly impossible to generalise symptoms as per psoriasis. Although, what is common in every psoriasis is a rash- red, flaky and silver coated cover that sheds.  Another common symptom is intense itching and burning sensation in the body.  The distinct symptoms are organised by psoriasis, below-

  • Plaque Psoriasis

The symptoms include rash covered with a silver coating, reddened around the skin. The common areas for these rashes to appear are extensor surfaces, i.e. back of a knee or inside of an elbow. Scratching of these rashes can cause a pint of blood loss, also known as Auspitz sign.

Occasionally, the plaque psoriasis on the scalp is mistaken for dandruff. To distinguish between the two, always note that dandruff can cause dry, silvery sheen scalp. On the other hand, plaque psoriasis will leave patches on the back of head or neck, thereby generalising and affecting the whole area.

  • Inverse Psoriasis

To identify inverse psoriasis, it is important to take into account that such psoriasis generally found in skin fold such as in the armpit, groins, buttocks, breast, and genitals.  The logical reason for such psoriasis to be found in skin fold is due to the presence of moist. Inverse psoriasis is smooth and glistening in nature unlike another psoriasis, hence more easily identifiable. The occurrence of such psoriasis commonly takes place in people suffering from the problem of overweight.

  • Nail Psoriasis

The most identifiable symptom of nail psoriasis is small dents or pits on the part of toenail or fingernail. To see it clearly, it is best advisable to illuminate the nail and removing any thread of doubts. Sometimes, nail psoriasis can lift the nail away from the skin, causing blood loss and clotting. At worse case, the nail will become thick and crumbly, holding a constant itch and pain.

  • Guttate Psoriasis

Gutta is the Latin word for a drop. Hence going by the name, the rashes of guttate psoriasis can be characterised to be shaped like a teardrop. They generally occur in legs, arms or torso. The trigger of guttate psoriasis can be stress, skin injury, high blood pressure or abuse of certain medications.

  • Erythrodermic Psoriasis

Under this psoriasis, the skin may look burned, and it can be identified by tracing the shedding of skin all over the body. The common symptoms of Erythrodermic psoriasis include alleviated heart rate, itching, burning, change in body temperature and severe illness.  Erythrodermic psoriasis is severe and life-threatening, as it may cause heart failure or pneumonia.

  • Pustular Psoriasis

Such psoriasis is characterised by rashes filled with puss. The dilution of puss involves lymph fluid and white blood cells. Pustular psoriasis commonly occurs in small areas of the body like the sole of the feet, finger, toes or palm of the hands. However pustular psoriasis holds an exception known as von zombush psoriasis, under which such rashes develop as reddened skin all over the body. The common symptoms included are fever, exhaustion, weight loss, dehydration, alleviated pulse, chills, and muscle weakness.

Causes of Psoriasis

According to the National Psoriasis Foundation, the following can be the causes of giving birth to this disease-

  • Genetics

Psoriasis is an autoimmune disease, and this malfunctioning of the immune system can be derived from the parent genes. However, National psoriasis foundation is unable to develop a full understanding of having this condition. At present, it is known that around 25 variations in gene pattern can cause this autoimmune disease.

  • Skin injury

The koebner phenomena says that any scrap, cut or even having a tattoo on the skin, may lead to the condition of psoriasis. The factor does not play a role in isolated form but is a combination of adhesion molecules, cytokines, and stress proteins. The development of psoriasis does not require a major injury, as at times little scrubbing or scratching of skin can lead to this condition.

  • Obesity

It has been speculated that obesity can be one of a factor causing psoriasis. As the accumulation of fat leads to a rise in cytokines, i.e. an increase in the creation of inflammatory proteins in the body.  The areas where such accumulation is largest, get prone to formation of plaques and thereby vulnerable to psoriasis.

  • Smoking

It has been identified that along with much harmful implication smoking holds, psoriasis adds on the number. There is a direct relationship between smoking and increase in inflammatory hormones of the body. Even the people under treatment for psoriasis, who continue to smoke, does not attain its full benefits.

  • Medications

There is a certain class of drugs which has been speculated to make a person more vulnerable to psoriasis. Such class of drugs includes- beta blockers, interferon’s, terbinafine, lithium, altace etc. Even the medication prescribed for the treatment of psoriasis can worsen things up. They hold many side-effects and may lead psoriasis to return, in more lethal form.

Diagnosis for Psoriasis

  • Self-Diagnosis

A person may not be able, but after cross-checking with the symptoms mentioned above, he shall get a sign for booking a medical appointment. The person shall keep an eye on rashes and reddening of the skin. Any rash or bump that is unfamiliar or mysterious shall be a prompt for the meeting with a reputable doctor.

  • Medical History

A doctor will be able to more clearly identify the situation of a person after having a look at his medical history. The doctor will additionally ask questions that are relevant to diagnosis, such as having any recent tattoo or cut in the body. The doctor will then pen down all the useful data, to conclude the diagnoses.

  • Medical Tests

In certain condition, the doctor can have an unsure opinion, by medical history and visual examination. As sometimes, it is difficult to distinguish the disease from their symptoms. In such a scenario, the doctor may ask the person for certain tests by taking the sample of infected skin and observing it under the microscope.

Treatment for Psoriasis

  • Topical Treatment

This is the first line of treatment which aims at slowing down the growth of psoriasis and controlling the inflammation of the body.  It is readily available on prescription, over the counter, on both steroid and non-steroid basis.

  • Phototherapy

Under this, the skin of the person diagnosed with psoriasis is exposed to ultraviolet light. This is done under the supervision of trained medicals. Phototherapy is also known as light therapy.

Usually, psoriasis medication can have side effects so people prefer home remedies.

  • Home Remedies

The following can be done to manage psoriasis and cope with it

-Quitting smoking

-Quitting excessive intake of alcohol

-Meditation

-Balance Diet for Psoriasis

-Exercising and keeping weight under control

-Joining a support group

Sagar Papneja

For me, health is about sustainable living and consuming environmentally conscious food; I am a vegan.

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