Plaque Psoriasis

  • Plaque psoriasis (also known as psoriasis vulgaris) is the most common form of psoriasis, affecting approximately 90% of patients.
  • Plaque psoriasis has the appearance of plaques of inflamed red skin covered by a flaky white buildup called scale.
  • The top scales flake off easily and often, but those beneath the surface of the skin clump together. Removing these scales exposes tender skin, which bleeds and causes the plaques (inflamed patches of skin) to grow.
  • Plaque psoriasis can develop on any part of the body, but most often occurs on the elbows, knees, scalp, and trunk.
  • Some treatments that may be effective in treating plaque psoriasis include topical steroid, topical vitamin D or a combination of both, phototherapy, systemic drugs and biologic therapies. Visit Treatments for Psoriasis and Psoriatic Arthritis for more information about treatments for plaque psoriasis.
chronic plaque psoriasis

Guttate Psoriasis

  • Named for the Latin word gutta, which means a “drop”.
  • Guttate psoriasis is characterized by small, red, drop-like dots that enlarge rapidly and may be somewhat scaly.
  • It is often found on the arms, legs, and trunk and sometimes in the scalp.
  • Guttate psoriasis can clear up without treatment or disappear and resurface in the form of plaque psoriasis.
  • Guttate psoriasis can sometimes appear scaly, and often develops suddenly after an infection (such as strep throat).

Some treatments that may be beneficial in the treatment of guttate psoriasis include:

guttate psoriasis

Pustular Psoriasis

  • Pustular psoriasis usually occurs in adults.
  • It is characterized by blister-like lesions filled with non-infectious pus and surrounded by reddened skin.
  • Widespread, acutely painful plaques of inflamed skin develop suddenly.
  • Pustules appear within a few hours, then dry and peel within two days.
  • Pustular psoriasis may be limited to one part of the body (localized) or can be widespread.
    • Generalized (widespread) pustular psoriasis is also known as Von Zumbusch pustular psoriasis. Generalized (widespread) pustular psoriasis can make life-threatening demands on the heart and kidneys.  Make sure to discuss any other symptoms you are experiencing with your health care provider.
  • Pustular psoriasis most commonly affects the hands and the feet.
  • Pustular psoriasis may be the first symptom of psoriasis, or it may develop in a patient already affected by chronic plaque psoriasis.

Some treatments that may be beneficial in the treatment of pustular psoriasis include:

Systemics
  • Acitretin
  • Cyclosporine
  • Methotrexate
  • Phototherapy
Biologics
  • Infliximab
  • Adalimumab
  • Etancercept
  • Ustekinumab
  • Secukinumab
  • Brodalumab
Topicals
  • Topical corticosteroids
  • Topical Vitamin D Analogues
  • Combination Therapy
Supplied by Waikato District Health Board

Supplied by Waikato District Health Board

Inverse Psoriasis

  • Inverse psoriasis occurs in the armpits and groin, under the breasts, and in other areas where the skin flexes or folds.
  • This disease is characterized by smooth, inflamed lesions and can be debilitating.
  • Inverse psoriasis is also known as intertriginous or flexural psoriasis.
  • Inverse psoriasis in more common in individuals who are overweight.

Some treatments that may be beneficial in the treatment of inverse psoriasis include topicals such as:

  • Topical corticosteroids
  • Topical Vitamin D3 Analogues
  • Topical Calcineurin Inhibitors (pimecrolimus, tacrolimus)
  • Topical Antimicrobials
  • Emollients
  • Tar-based products
Supplied by Prof. Raimo Suhonen

Supplied by Prof. Raimo Suhonen

Erythrodermic Psoriasis

  • Erythrodermic psoriasis is characterized by severe scaling, itching, and pain that affects most of the body
  • Erythrodermic psoriasis disrupts the body’s chemical balance and can cause severe illness.
  • This particularly inflammatory form of psoriasis can be the first sign of the disease, but often develops in patients with history of pre-existing plaque psoriasis.
  • While erythrodermic psoriasis is rare, it is important to consult a physician immediately if it does occur. Erythrodermic psoriasis can be life threatening.

 

Some treatments that may be beneficial in the treatment of erythrodermic psoriasis include:

Systemics
  • Acitretin
  • Cyclosporine
  • Methotrexate
Biologics
  • Infliximab
  • Etancercept
Combination therapy 
erythrodermic psoriasis

Scalp Psoriasis

Scalp psoriasis is a form of psoriasis that appears on the scalp. Depending on the severity of scalp psoriasis, it may appear as a fine scaling in mild forms to thick crusted plaques in more severe forms.

Some treatments that may be beneficial in the treatment of scalp psoriasis include:

Systemics
  • Acitretin
  • Cyclosporine
  • Methotrexate
  • Phototherapy
  • Intralesional corticosteroid injections
Biologics
  • Infliximab
  • Adalimumab
  • Etancercept
Topicals
  • Calcipotriene
  • Topical Vitamin D Analogues
  • Combination topical therapy
  • Salicylic acid
  • Anthralin
  • Coal tar shampoo
  • Tazarotene

Nail Psoriasis

  • Nail psoriasis is a form of psoriasis that occurs when psoriasis arises in the nail bed.
  • It can appear as discolouration of the nail, tiny dents in the nail, fragile nails, blood under the nails, or the nail separating from the finger or toe.
  • Nail psoriasis typically develops in patients who already have plaque psoriasis.

Some treatments that may be beneficial in the treatment of nail psoriasis include:

Oral and biologic medications are only recommended for nail psoriasis if psoriasis is present in substantial amounts elsewhere on the body and/or if the above treatments have failed.

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