Psoriasis Types: Top 5 Different Types of Psoriasis Disease

Psoriasis, an autoimmune skin condition, can cause considerable discomfort in the affected person, limiting them form enjoying their lives. To improve the overall quality of the patient’s life, a doctor will prescribe suitable treatment after diagnosing the type of psoriasis they have. Most people are affected with plaque psoriasis, but they can develop other types of psoriasis during or after the treatment due to some triggers.

You can learn about the different types of psoriasis diseases here, their associated symptoms, and their treatment methods. You should not self-medicate if you think you have psoriasis as you can easily end up triggering the condition and making it worse; always consult your doctor before changing or stopping your medication to avoid complications.

Types of psoriasis disease

Knowing which type of psoriasis you have is important for the doctor to prescribe suitable treatment and for you to manage the condition. It is also possible for a person to have two types of the psoriasis disease at different times in their lives. They may not have both of these together, but symptoms for a different type of psoriasis disease can emerge from a trigger after the symptoms of the previous psoriasis type recede. Listed below are the different types of psoriasis disorders:

Plaque psoriasis

The most common type of psoriasis, plaque psoriasis (or psoriasis vulgaris) occurs in about 80% patients with psoriasis. This psoriasis type patients present with symptoms such as raised and inflamed red (or purple for darker skin tones) skin patches that have white or silver scales on top. These patches can itch or burn and can appear anywhere on the body, especially in areas such as the scalp, elbows, knees, or lower back.

The treatment for plaque psoriasis usually involves a combination of following three approaches:

a. Topical medication, which may have steroids, to slow skin cell growth and ease the inflammation
b. Phototherapy using ultraviolet light to suppress the overly active immune system, reduce inflammation, slow down the rapid growth of skin cells, and allow the skin to heal
c. Systemic medication, including biologics drugs, to treat patients with moderate to severe plaque psoriasis disorder who haven’t responded to other treatments

Guttate psoriasis

Affecting about 8% of people with psoriasis, this type of psoriasis often occurs in children and young adults. People with guttate psoriasis develop small pink-red (or purplish for darker skin tones) spots all over their skin. It is likely that guttate psoriasis will go away on its own in some time, but more stubborn cases of this psoriasis require treatment. The most common triggers for this type of psoriasis include streptococcal infection, certain medicines, stress, injury to the skin, and other infections.

Phototherapy, oral medication, or a combination of treatments is usually recommended to treat stubborn cases of this psoriasis type.

Inverse psoriasis

Also known as intertriginous psoriasis, inverse psoriasis can affect about 21%–30% of people living with psoriasis. This type of psoriasis disease causes red (or purple) inflamed patches on skin folds such as the armpits, elbows, knees, genital area, and under breasts. Friction and sweating can cause the symptoms of inverse psoriasis to worsen. Some common triggers for inverse psoriasis include infections, tobacco or alcohol use, and friction on deep skin folds. The sweat in the skin fold region creates a moist environment that eliminates the white/silvery scales generally associated with psoriasis.

The care plan for inverse psoriasis usually involves topical treatments for most cases and systemic medications for severe cases. Your doctor may prescribe additional medicines and certain lifestyle changes to avoid the risk of getting yeast or fungal infections in the affected areas.

Pustular psoriasis

A persistent form of psoriasis disease, pustular psoriasis is quite uncommon (occurring in about 3% of patients with psoriasis) and mostly affects adults. The symptoms of this psoriasis type usually involve pus-filled painful bumps (or pustules) surrounded with inflamed, reddened (or purplish), or discoloured skin. The pustules are usually not contagious.

Pustular psoriasis is further categorised into two categories—generalised and localised pustular psoriasis.

a. Generalised pustular psoriasis (GPP) develops suddenly and can progress fairly quickly throughout the body. The pustules are often accompanied by fever, chills, severe itching, muscle weakness, fatigue, and changes in the heart rate. This type of psoriasis is extremely difficult to treat, and the patient requires immediate medical attention.
b. Localised pustular psoriasis (LPP) causes pustules to appear in specific areas—mostly hands and/or feet.

i. Palmoplantar pustular psoriasis (PPPP) only affects the palms and/or the soles.
ii. Acrodermatitis continua of Hallopeau (ACH) only affects the tips of the fingers and/toes, especially the nails.

Being one of the most difficult forms of psoriasis, it is often treated with a combination of topical ointments, phototherapy, oral medication, and biologics.

Erythrodermic psoriasis

This is a rare psoriasis condition that affects only about 2% people living with psoriasis. Erythrodermic psoriasis causes most of the patient’s skin to appear burnt and fiery and sudden changes in body temperature. The inflamed skin itches and burns severely and may even peel out. It is a serious condition that requires hospitalisation of the patient. You should see your doctor immediately if you think you have this condition. Congestive heart failure, pneumonia, and infection are some of the complications associated with erythrodermic psoriasis caused by fluid and protein loss.

Suddenly stopping your systemic treatment for psoriasis, severe sunburn, and infections among others can trigger this psoriasis type. Treatment for this type of psoriasis involves restoring the body’s normal temperature and fluid levels. Once the erythrodermic flare has passed and other symptoms subside, the doctor may recommend oral medication, biologics, or topical treatments to manage this type of psoriasis.

Nail psoriasis
Up to 50% of people with psoriasis notice changes in their nails; nail psoriasis occurs in about 90% of people who have psoriatic arthritis (explained next). The common symptoms of this type of psoriasis include tenderness or painful nails, pitting of nails, nails spreading from the nail bed and yellow–brown appearance of the nails. People with nail psoriasis are more likely to get fungal infections. Treatment for this type of psoriasis may include topical ointments, intra lesion also steroids, phototherapy, biologics, and oral treatments.

Psoriatic arthritis
Psoriatic arthritis causes joint pain and inflammation along with psoriasis. More than 80% of cases of psoriatic arthritis report to have had psoriasis for about an average of 12 years before getting this condition. Apart from the painful and stiff joints, people with psoriatic arthritis can also have sausage-like fingers and toes as well as warm joints that may be discoloured. The early diagnosis of this condition can help reduce join damage and manage the condition better.