Psoriasis – Typical Symptoms:
Discovering psoriasis demands looking for characteristic skin changes which in many instances have a preference for specific body parts. Thickening of skin, scaling and redness are all distinctive changes seen in psoriatic skin. Additionally, psoriasis can affect not just skin, but nails, scalp, and joints as well. In other words, psoriasis has findings typical for both what and where.
Psoriasis – Key features include:
What is Guttate Psoriasis, Pustular Psoriasis and Erythrodermic Psoriasis -
These less common appearances of psoriasis differ dramatically from the typical plaque type. In Guttate (drop-like) psoriasis, little papules (lesions which can be felt and are less than 1cm in diameter) look scattered throughout the skin. Pustular psoriasis can appear in smaller areas or include most of the body with countless tiny white pustules. Eythrodermic Psoriasis occurs when the entire body changes bright red and scaly. In this instance, a skin biopsy may be needed to separate erythrodermic psoriasis from other diseases which also can cause a universally red and scaly skin (known as exfoliative erythroderma or “red man”).
What is Auspitz’s Sign?
When adherent psoriatic scales are scrathched or picked off, point bleeding known as Auspitz’s sign may occur. The pinpoint areas represent the tops of tiny capillaries which undulate vertically throughout the thickened psoriatic skin.
Plaque-type psoriasis is the most common form of the disease, hence the name psoriasis vulgaris. The three trademarks of a plaque of psoriasis are: thickened skin, red skin and skin scales. The thickness of a plaque (a raised skin lesion more than 1cm in diameter which can be felt) can vary from hardly perceptible to several millimeters thick. They range in color from a light pink to thick beefy red. In patients with dark-skinned, there may be little redness and more darkening of the skin. Scales can comprise from virtually absent to dense oyster-shell like adherent plates known as ostraceous scales.
Psoriasis- Koebner Phenomenon
The Koebner phenomenon (Koebnerization, isomorphic response) appears when a new area of psoriasis develops in injured skin. For instance, after a surgery, psoriasis might develop around the surgical scar. This development may also help explain why psoriasis tends to appear on areas of constant low-intensity trauma such as elbows and knees. Koebnerization can appear after non-traumatic skin injury such as a sun tan, or an allergic reaction to a medication. In patients who suffer from dandruff or seborrheic dermatitis of the face and scalp, psoriasis can superimpose itself due to irritation and scratching and a crossover or combination dermatitis known as “sebopsoriasis” develops. Koebnerization is not specific to psoriasis.
Where- Finger and Toenails Psoriasis:
Nail changes normally seen in psoriasis include thickening, lifting, and pitting of the nails. “Oil spotting” (darkened areas where the nail appears translucent similar to the effect of placing a drop of oil on a sheet of paper) are fairly specific for this disease. Treatment of nail psoriasis can be difficult.
Psoriasis – Typical Locations
Plaque type psoriasis generally involves particular locations on the body including the scalp, elbow, knees, genitals, belly button (umbilicus) and buttocks area (sacrum and intergluteal cleft). In moist areas such as the armpits, under breasts or in the groin, scales become softened (wet and pasty) and the lesions take on a moist, red and raw appearance closely mimicking a yeast infection in appearance. On the scalp, a severe form of dandruff-like flaking and scaling can be seen.
Where- Joints(Psoriatic Arthritis)
Psoriatic arthritis is an inflammatory arthritis which can affect up to 10% of patients with moderate to severe psoriasis. Five clear-cut patterns of arthritis appear in psoriasis which can sometimes be identified from rheumatoid arthritis by x-ray findings or blood tests.
Where- Hand and Foot Lesion Psoriasis:
Psoriasis of the hands and feet can have either a plaque like appearance as seen in other body areas, or a pustular appearance. The existence of pustules is generally attributed to infections, however in psoriasis, pustules form as a part of the inflammatory response. Very thickened plaques on the palms or soles, being somewhat inflexible, may crack with movement. The resulting fissures can be painful and sometimes become secondarily infected. Severe foot lesions can result in disability by limiting your ability to walk.