Psoriasis is an autoimmune disease, meaning the cells of your immune system have gone rogue. Mistreating and attacking healthy cells in your body as foreign cells.
When your immune system senses foreign invaders, it discharges an army of proteins to attack healthy cells. Escalating the production of skin cells in four to seven days, as opposed to the normal 21 to 28 days.1 Causing new cells to grow way too quickly on the surface of the skin.
The look and feel of psoriasis are flaky skin, scaly skin, red skin, itchy skin, burning skin, patches, and plaques. Psoriasis skin looks thicker and more inflamed compared to other skin conditions.
2 Your dermatologist may perform a biopsy on your skin lesion to examine it more closely. Discover six different types of psoriasis that you need to know before getting them confused with other skin conditions.
1. Plaque psoriasis
The most prevalent type of psoriasis. A staggering 80% of patients with psoriasis have plaque psoriasis. The plaques look dry, reddish and raised, covered by silver-white scales. The appearance of the plaques is unpredictable. They can show up anywhere on the body, including elbows, knees, genitals, and on the belly button. 3
2. Guttate psoriasis
A relatively uncommon form. Lesions are small, itchy, droplet-looking, salmon-pink (or red) spots, covered by a fine scale. Outbreak can occur on the body, face, ears, scalp, arms, or legs. Rarely appears on the palms and the bottoms of the feet. 4
3. Inverse psoriasis.
More common in people who are overweight. Red patches that are smooth, shiny, and painful. As the name suggests, it mainly occurs in skin folds and hidden areas: buttocks, armpits, groin, under the breasts, and around the genitals. Friction and sweating worsen the situation.5
4. Pustular psoriasis.
A rare form of psoriasis. Skin becomes fiery red, dry, and tender, with blisters filled with pus. Pustular psoriasis can appear on any part of the body, but it usually shows up on the palms, fingers, toes, and the soles of the feet. Effectively disabling the use of your hands and legs. 6
5. Erythrodermic psoriasis.
The rarest type of psoriasis. Only 3% of patients with psoriasis catch it once or more in a lifetime. Lesions are not clearly defined. The entire body is covered with a red, peeling rash that causes the skin to itch, burn, or irritate immensely. Erythrodermic psoriasis can be life threatening. It requires immediate medical attention. 7
6. Psoriatic arthritis.
A common type of psoriasis that affects skin and joints. Develops in adults between 30 and 50 years old. A combination of inflamed, scaly skin and painful, stiff, swollen joints. It can appear on any part of your body, such as fingertips, wrists, knees, spine, lower back, or ankles. Early diagnosis and treatment of psoriatic arthritis is imperative to prevent permanent deformity. 8
Don’t Scratch Your Head! 4 Skin Problems That Resemble Psoriasis
There are many types of skin conditions out there, it can be confusing. To the untrained eye, a patch of scaly skin may look a lot like psoriasis. The real difference lies in the shape of the edges of the affected area, the colour, and the thickness of the scales.
1. Eczema. Also known as atopic dermatitis. It looks very much like psoriasis. Dry, red, flaky skin, but the condition is not contagious. Eczema usually occurs in places where the skin will bend, such as: hands, feet, elbows, or fingers; psoriasis can occur almost anywhere like on your face, scalp or palm.
Children may experience mild itching with psoriasis, but they may experience intense itching with eczema.9 Your dermatologist is able to tell both skin conditions apart based on their trained eye, the amount of itch, and the affected areas.
2. Dandruff. A very common condition. It looks very similar to scalp psoriasis. Both produce skin flakes on the scalp, but their symptoms are different. Dandruff gives you white, oily flakes, 10 whereas psoriasis gives you red patches of inflamed skin, covered with silver-white scales. These scales (or plaques) may be painful. Scratching may cause the skin to bleed. Dandruff is rarely serious and it is easier to treat.
3. Seborrheic dermatitis. A yeast rash that can be confused with scalp psoriasis. It may cause long-term distress. Shares symptoms of psoriasis, such as itchy, scaly, and red skin. Seborrheic dermatitis skin looks swollen and greasy, covered with crusty white or yellowish scales. 11 Skin flakes may attach to the hair shaft. Psoriasis on the other hand, can cross the hairline and extend beyond the scalp.
4. Scabies. A contagious skin condition. Caused by infestation of tiny mites that you can pick up from your bedding, clothes, and furniture. 12 Although scabies can develop anywhere on the skin, these mites prefer to dwell in certain parts of the body, such as: hands, fingertips, arms, elbows, wrists, and skin that is usually covered by clothing or jewellery.13 Scabies can be mistaken for psoriasis due to itchiness, little bumps of rash, scaly patches, or thick crusts on the skin. Avoid direct, skin-to-skin contact with others. It will go away once treated.
Follow Your Dermatologist’s Advice
Currently, there is no cure for psoriasis, but there are many types of treatment for psoriasis. It is crucial to follow your dermatologist’s advice. There are so many things that you can do to prevent flare-ups and still look at your best.
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See also: Scalp Psoriasis: 6 Tips That Will Help You Look Sharp
Dr Ch’ng obtained his specialty training from the Royal College of Physicians in London. Subsequently, he obtained his Advanced Masters in Dermatology from the National University of Malaysia. He was previously the Head of Dermatology of the State of Pahang and Hospital Sungai Buloh.
His call to dermatology started way before he even contemplated doing medicine. His father suffered from severe psoriasis, and was in and out of hospital a lot in the late 1970s. His father’s condition made him see that skin disease is not just an aesthetic problem, as it can cause the patient and the entire family so much grief. His practice today reaffirms his belief, with many patients expressing deep relief and gratitude after their treatment.
Place of Practice
Dr. Ch'ng is a NSR registered consultant dermatologist. She graduated as a gold medalist from Univeristy Malaya in 2006. She obtained Membership of the Royal Colleges of Physician of the United Kingdom in 2010 and joined dermatology team in University Malaya in the same year. She completed Advanced Master in Dermatology (UKM) in 2014 and a visiting fellowship in Cutaneous Laser Surgery in Mahidol University (Thailand) in 2017. Her special interest include acne, psoriasis, urticaria, contact dermatitis/eczema and procedural dermatology.
Dr. Ch'ng started her instagram account @cccskindoc providing free skin care tips and education to public. She believes everyone deserves up-to-date and accurate information on skin care to embrace the skin that he or she is in.
Place of Practice
Dr Khor graduated from National University of Malaysia (UKM), Kuala Lumpur in 2002. He obtained his Internal Medicine specialty training from the Royal College of Physicians of London in 2007 and further subspecialized in Dermatology by obtaining his Advanced Master in Dermatology from UKM in 2013. Dr Khor served as the Head of Dermatology service for Perlis from 2013 to 2015 before transferring back to Penang. Currently, he is the Deputy Head of Department of Dermatology in Hospital Pulau Pinang. He is also a visiting consultant dermatologist at KPJ Penang Specialist Hospital and Northern Skin Specialist Clinic.
Dr Khor is active in academic activities, performing as an honorary lecturer for Allianze University College of Medical Sciences and Penang Medical College. He is active in research as well with the publication of original papers in dermatological journals and serves as a reviewer for Malaysian Journal of Dermatology. His dedication to the profession earned him Excellent Service Award from the Ministry of Health in 2009 and 2017.
Place of Practice