The most common form of psoriasis is plaque psoriasis - about 80 percent of us who have the disease experience this kind - and typically you only have one type at a time. But psoriasis can appear in a number of forms; I’ve personally had two kinds: plaque and guttate. I was diagnosed with plaque psoriasis as a teenager, experienced remission on and off through subsequent years, and as often happens, a severe guttate flare (triggered by a case of strep throat) eventually turned to plaque psoriasis.
Read on to learn about the different types of psoriasis. In my next post, I’ll share specific treatment options for each kind.
This form of psoriasis is characterized by raised, inflamed, red lesions covered by a silvery white scale. It’s usually found on the elbows, knees, scalp and lower back.
Pronounced GUH-tate, this kind of psoriasis often starts in childhood or sometime during the teens and 20s. It appears as small, red, individual spots on the skin, typically appearing on the trunk and limbs. These spots - named “guttate” for the Latin word meaning “drop” - are not usually as thick as plaque lesions.
Guttate psoriasis often comes on quite suddenly, which I can attest to. I’m confident that my two separate flares over the past five years were due to painful throat infections, likely strep throat. A variety of conditions can bring on an attack of guttate psoriasis, including upper respiratory infections, streptococcal throat infections (strep throat), tonsillitis, stress, injury to the skin and the administration of certain drugs including antimalarials and beta-blockers.
This type of psoriasis is found in the armpits, groin, under the breasts and in other skin folds around the genitals and the buttocks. It appears as bright-red lesions that are smooth and shiny, and can prove to be easily irritated from rubbing and sweating because of its location in tender areas. Those who are overweight or have deep skin folds may find this kind of psoriasis especially uncomfortable.
This form, mostly seen in adults, is characterized by white blisters of noninfectious pus (consisting of white blood cells) surrounded by red skin. There are three types of pustular psoriasis. It may be localized to certain areas of the body, such as the hands and feet, or it may cover nearly all of your body. It begins with the reddening of the skin followed by formation of pustules and scaling. Possible triggers: internal medications, irritating topical agents, overexposure to UV light, pregnancy, systemic steroids, infections, stress and sudden withdrawal of systemic medications or potent topical steroids.
Pronounced eh-REETH-ro-der-mik, this type of psoriasis is particularly inflammatory that affects most of the body surface. It may occur in association with von Zumbusch pustular psoriasis, and is characterized by periodic, widespread, fiery redness of the skin and the shedding of scales in sheets, rather than smaller flakes. The reddening and shedding of the skin are often accompanied by severe itching and pain, heart rate increase and fluctuating body temperature.
If you’re experiencing the symptoms of erythrodermic psoriasis flare, you should go see a doctor immediately because it causes protein and fluid loss that can lead to severe illness. The condition may also bring on infection, pneumonia and congestive heart failure. People with severe cases of this condition often require hospitalization. Known triggers of erythrodermic psoriasis: abrupt withdrawal of a systemic psoriasis treatment including cortisone; allergic reaction to a drug; severe sunburns; infection; and medications such as lithium, anti-malarial drugs; and strong coal tar products.