Psoriasis vulgaris: This is one of the most common forms of psoriasis, and is also called plaque psoriasis. Seen in almost 9 out of 10 psoriasis patients, it displays red, raised patches with silvery scales..
Guttate psoriasis: Small, raindrop-like lesions may develop on the trunk and limbs. Several weeks after a throat infection (particularly streptococcal), this form may develop suddenly. It is commonly seen among children.
Pustular psoriasis: The lesions are filled with pus, besides having other peculiar characteristics. If the pus-filled lesions spread all over the body, it can be very dangerous, and will require immediate medical intervention.
Inverse psoriasis: Bright red, smooth patches are seen in the folds of the skin. Common areas that are affected are under-breasts, underarms, genital areas, under the buttocks and under abdominal folds.
Erythrodermic psoriasis: This is a rare form of psoriasis, and can be quite serious. Patients develop intense redness and scaling almost all over their body, often accompanied by the copious shedding of scales. This can be triggered by severe sunburn, intake of steroids, etc. In severe cases, the patient may develop dehydration, fever and infection, requiring hospital admission.
Nail psoriasis: Fingernails and toenails are also affected by psoriasis. In many cases, they appear discoloured, thickened, pitted or ridged, and they crumble or detach from the nail-bed.
Scalp psoriasis: Scalp psoriasis affects almost half the people who develop skin psoriasis. It leaves the scalp dry with scaly or heavily crusted plaque areas. The plaque flakes off or peels off in clusters.
Psoriatic arthritis: Joints are affected in about 2 to 5% psoriasis patients. Symptoms include swelling, stiffness and pain in the affected joints. This can be quite crippling in the advanced stages.
Palmo-plantar psoriasis: Typically, lesions are seen on the palms and soles of patients with this type of psoriasis.
Effects of psoriasis on other parts of the body
Joints: Psoriasis is associated with joint problems in about 5 to 10% patients. In fact, joint pain may sometimes be the only sign of the disorder, with the skin being completely clear. The joint disease associated with psoriasis is referred to as psoriatic arthritis. Patients may have inflammation on any joints, although joints of the hands, knees and ankles tend to be most commonly affected. It is a destructive form of arthritis, and is treated with medications to stop the progression of the disease. The average age for the onset of psoriatic arthritis is 30 to 40 years. Usually, skin symptoms precede the onset of arthritis.
Nails: Psoriasis may solely involve nails in a small number of patients. Usually, these signs accompany skin infections as well as arthritis symptoms. Nail psoriasis is, typically, very difficult to treat.
Life with psoriasis
Life with psoriasis can be hard. There are several situations that may bother psoriasis patients, which also need to be managed and dealt with patiently, along with lesions. Itching, stress, disfigurement of the affected parts, social life, marriage, etc., often become areas of grave concern for the sufferer. Some of the common problems are described below:
Stress: Stress is a common trigger for a psoriasis flare. Ironically, a psoriasis flare may also cause stress. According to the National Psoriasis Foundation’s “Mental Health Issue Brief”, psoriasis is independently associated with stress-related disorders. Women, in particular, seem vulnerable to stress from psoriasis.
Inflammation: This is the body's way to cope with stress. Your immune system responds to injury and infection by sending out chemicals that cause inflammation, which helps to heal a wound. The immune system of a psoriasis patient over-responds; it sends out too many chemicals. This makes managing stress particularly challenging for the patient. Meditation, exercise and other stress management techniques help to cope with mental stress.
Itching: The itch of psoriasis may have a bigger impact on the quality of life. By keeping the skin moisturised, scaling and flaking are minimised. Cold showers and cold packs can also provide relief.
Relationships: It can be difficult to talk to friends and family about psoriasis, and how it affects your life. It is a visible disease that can affect relationships in a number of ways. People shy away from dating if they suffer from poor body-image issues due to psoriasis. Genital psoriasis can have a significant impact on sex and intimacy. It can interfere with a romantic relationship. However, genital psoriasis usually does not interfere with sexual function.
Depression: People with psoriasis are more likely to become depressed. It has been said that depression is the topmost co-morbidity of psoriasis. People with psoriasis are twice as likely to become depressed as compared to the rest of the population. Doctors believe that the biological changes that cause psoriasis may also cause depression. The social stigma of visible psoriasis can also trigger depression.
Work: Working with psoriasis and psoriatic arthritis can be challenging. You may need to take time off for doctor appointments or ask for changes to your work.