Psoriasis: Types

Psoriasis can appear in a variety of forms:

Plaque Psoriasis: (Psoriasis Vulgaris)

Plaque psoriasis is the most common type of psoriasis, typically you will see well defined red patches with dry, silvery scales on your scalp, elbows, knees, lower back and around the belly-button. Your face will not usually be involved. If the scales are picked off, small points of bleeding will typically occur. You may see thick areas of scaling on the palms of your hands and the soles of your feet, individual patches may last for months to years, and may come and go.

Plaque psoriasis - On elbow		Plaque psoriasis - On knees

Guttate Psoriasis:

Guttate psoriasis is named after the French word for drop “goutte” since the lesions are multiple, small (5-15 mm), round, or oval and drop-like in shape. They will typically cover your trunk, arms, legs, face and scalp. This form of psoriasis is seen mainly in children and young adults after a Streptococcal throat infection. It is the presenting form of psoriasis in approximately 15% of people and often goes away on its own within a few weeks or months.

Guttate psoriasis - On the back		Guttate psoriasis - A closer look

Inverse Psoriasis:

Inverse psoriasis refers to psoriasis that occurs in the creases and folds of your skin for example, armpits, groin and under the breasts. The lesions are well defined red patches, but scaling is often not present or is minimal.

Inverse psoriasis - Groin area

Pustular Psoriasis:

Pustular psoriasis may be found in one localized area or spread over many areas of your body. Although pustules are seen in this form, they do not represent an infection and are not contagious.

A) Localized pustular psoriasis:

One or more patches of psoriasis spontaneously develop small pustules. Irritation and aggressive over treatment may also induce this form of psoriasis.



Localized pustular psoriasis B) Palmoplantar pustulosis:

Palmoplantar pustulosis is a localized form of pustular psoriasis, which occurs on the palms of your hands and the soles of your feet. It is chronic, persistent, symmetrical and difficult to treat, it typically affects middle-aged women.

Pustular psoriasis - On sole of foot		Pustular psoriasis - a closer look

C) Acropustulosis:

Acropustulosis is a localized form of pustular psoriasis that affects fingers, thumbs and toes. Pustules appear then burst leaving bright red areas that may ooze, become scaly and/or crusty. The nails are often abnormal, crumbly and may lift up because of underlying lakes of pus.



Acropustulosis - Pustular psoriasis involving the nail bed

D) Generalized (von zumbusch) pustular psoriasis:

This type of psoriasis usually reflects a worsening of the psoriasis. The skin becomes sore and red. Pin-point pustules develop and spread forming large patches. The skin folds and groin area are commonly involved. People with this rare type of psoriasis usually feel unwell, they may have a fever and a high white blood cell count, and occasionally die from this condition.



Generalized pustular psoriasis

Erythrodermic Psoriasis:

In erythrodermic psoriasis, most of the skin surface is involved with redness and scaling.

Nail Psoriasis:

Nail changes occur in 25-50% of people who have psoriasis, they are more common in people who also have psoriatic arthritis.

Small indents in the nails (“pitting”) are the most common nail changes, other changes include lifting up of the nails (“onycholysis”), discoloration, thickening and crumbling.

Psoriatic Arthritis:

Psoriatic arthritis occurs in approximately 5-10% of people who have psoriasis. It is more common in men when the psoriasis is generalized and/or pustular, the most common form involves only one or a few joints, often the knees. The small joints of the hands and feet may be swollen and deformed, nail changes are common if the arthritis affects the hands and feet. Back pain may indicate arthritis of the spine and/or sacroiliac joints. If you have joint pain or swelling, you should inform your physician that you also have psoriasis.

Psoriatic arthritis - Associated with skin and nail psoriasis



Psoriatic arthritis - A closer look



Please visit PsoriaticArthritisGuide.ca for more information on this condition.

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