SymptomsBy Mayo Clinic staff
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Psoriasis signs and symptoms can vary from person to person but may include one or more of the following:
- Red patches of skin covered with silvery scales
- Small scaling spots (commonly seen in children)
- Dry, cracked skin that may bleed
- Itching, burning or soreness
- Thickened, pitted or ridged nails
- Swollen and stiff joints
Psoriasis patches can range from a few spots of dandruff-like scaling to major eruptions that cover large areas. Mild cases of psoriasis may be a nuisance; more-severe cases can be painful, disfiguring and disabling.
Most types of psoriasis go through cycles, flaring for a few weeks or months, then subsiding for a time or even going into complete remission. In most cases, however, the disease eventually returns.
Several types of psoriasis exist. These include:
- Plaque psoriasis. The most common form, plaque psoriasis causes dry, raised, red skin lesions (plaques) covered with silvery scales. The plaques itch or may be painful and can occur anywhere on your body, including your genitals and the soft tissue inside your mouth. You may have just a few plaques or many, and in severe cases, the skin around your joints may crack and bleed.
- Nail psoriasis. Psoriasis can affect fingernails and toenails, causing pitting, abnormal nail growth and discoloration. Psoriatic nails may become loose and separate from the nail bed (onycholysis). Severe cases may cause the nail to crumble.
- Scalp psoriasis. Psoriasis on the scalp appears as red, itchy areas with silvery-white scales. You may notice flakes of dead skin in your hair or on your shoulders, especially after scratching your scalp.
- Guttate psoriasis. This primarily affects people younger than 30 and is usually triggered by a bacterial infection such as strep throat. It's marked by small, water-drop-shaped sores on your trunk, arms, legs and scalp. The sores are covered by a fine scale and aren't as thick as typical plaques are. You may have a single outbreak that goes away on its own, or you may have repeated episodes, especially if you have ongoing respiratory infections.
- Inverse psoriasis. Mainly affecting the skin in the armpits, in the groin, under the breasts and around the genitals, inverse psoriasis causes smooth patches of red, inflamed skin. It's more common in overweight people and is worsened by friction and sweating.
- Pustular psoriasis. This uncommon form of psoriasis can occur in widespread patches (generalized pustular psoriasis) or in smaller areas on your hands, feet or fingertips. It generally develops quickly, with pus-filled blisters appearing just hours after your skin becomes red and tender. The blisters dry within a day or two, but may reappear every few days or weeks. Generalized pustular psoriasis can also cause fever, chills, severe itching and fatigue.
- Erythrodermic psoriasis. The least common type of psoriasis, erythrodermic psoriasis can cover your entire body with a red, peeling rash that can itch or burn intensely. It may be triggered by severe sunburn, by corticosteroids and other medications, or by another type of psoriasis that's poorly controlled.
- Psoriatic arthritis. In addition to inflamed, scaly skin, psoriatic arthritis causes pitted, discolored nails and the swollen, painful joints that are typical of arthritis. It can also lead to inflammatory eye conditions, such as conjunctivitis. Symptoms range from mild to severe, and psoriatic arthritis can affect any joint. Although the disease usually isn't as crippling as other forms of arthritis, it can cause stiffness and progressive joint damage that in the most serious cases may lead to permanent deformity.
When to see a doctor
If you suspect that you may have psoriasis, see your doctor for an examination. Also, talk to your doctor if your psoriasis:
- Progresses beyond the nuisance stage, causing you discomfort and pain
- Makes performing routine tasks difficult
- Causes you concern about the appearance of your skin
- Leads to joints problems, such as pain, swelling or inability to perform daily tasks
Seek medical advice if your signs and symptoms worsen or don't improve with treatment. You may need a different medication or a combination of treatments to manage the psoriasis.
- Feldman SR, et al. Epidemiology, clinical manifestations, and diagnosis of psoriasis. http://www.uptodate.com/home/index.html. Accessed Nov. 22, 2010.
- Questions and answers about psoriasis. National Institute of Arthritis and Musculoskeletal and Skin Diseases. http://www.niams.nih.gov/hi/topics/psoriasis/psoriasis.htm. Accessed Nov. 26, 2010.
- Burden AD, et al. Diagnosis and management of psoriasis and psoriatic arthritis in adults: Summary of SIGN guidance. BMJ. 2010;341:987.
- Feldman SR, et al. Treatment of psoriasis. http://www.uptodate.com/home/index.html. Accessed Nov. 30, 2010.
- Light therapy. National Psoriasis Foundation. http://www.psoriasis.org/NetCommunity/Page.aspx?pid=430. Accessed Nov. 30, 2010.
- Living well: Healthy eating. National Psoriasis Foundation. www.psoriasis.org/netcommunity/learn_eating. Accessed Nov. 30, 2010.
- Aloe. Natural Medicines Comprehensive Database. http://www.naturaldatabase.com. Accessed Nov. 30, 2010.
- Fish oil. Natural Medicines Comprehensive Database. http://www.naturaldatabase.com. Accessed Nov. 30, 2010.