Types of Psoriasis
There are different types of psoriasis, a chronic non-infectious disease which mainly affects person’s skin. A typical manifestation of this pathological condition are the inflammatory sites, covered with a thick layer of silvery scales. As we have mentioned, there are numerous kinds and types of the disease. Let us have a detailed look at the problem and make clear what psoriasis types exist and what their main peculiarities are.
When talking about the classification of psoriasis, one should keep in mind that depending on the form of psoriasis there are two large groups that the disease is divided into. In their turn, each group includes several subgroups.
Pustular type which includes
- generalized form (pustular psoriasis of von Zumbusch, Hallopeau’s disease, Impetigo herpetiformis);
- palmoplantar form (palmar and plantar pustular psoriasis);
- annular type of psoriasis.
Non-pustular type of the disease includes
- traditional common form of late or early onset;
- erythrodermic psoriasis.
The forms of the disease which are not included in the main classification are:
- seborrhea-like condition;
- exudative form;
- psoriasis induced (caused) by the use of certain groups of drugs;
- napkin psoriasis;
- the atypical process that affects the skin folds and flexor surface of the extremities.
There are the following types of psoriasis according to the severity level of the disease:
Severe forms of the disease mean that a large area of skin is affected. In this case, the disease appears rapidly. Moreover, in this form of the disease arthritis also develops. Severe forms include erythroderma, pustular, exudative psoriasis, and psoriasis arthropica.
Generalized pustular psoriasis is considered to be the most dangerous type of the disease though it makes less than 1 percent of all the cases. It usually starts suddenly and is accompanied by pustules that form groups on a background of skin changes. Later the eruptions merge and cover vast areas. In addition to skin manifestations, there are also symptoms of intoxication (weakness, fever, chills, headache). The lesions are most typical of the delicate skin of the genital area and flexor surfaces and folds.
Exudative Form of the Disease
The exudative form of psoriasis may develop on the basis of the typical pattern and it may be distinguished by a significant vascular leakage, as well as by the development of the inflammatory reaction and leucocytic infiltration. Consequently, one will find scales of dirty yellow color on the surface of the plaque papules. When removed, they expose the wound surface. Most of these manifestations are formed in patients with concomitant systemic diseases (diabetes, hypothyroidism, obesity).
The development of psoriatic arthritis can accompany any type of psoriasis. It affects up to 7 percent of all patients. This condition is the most severe manifestation of the disease. Most often psoriatic arthritis affects young people with a genetic predisposition of the immune system. As a rule, the joints are affected after the appearance of skin changes. However, in some cases, the disease starts with the articular syndrome. In the majority of cases, the disease affects the distal interphalangeal joints of the toes, arms, and carpometacarpal joint. Occasionally, the pathological process occurs in the spine. The clinical picture is not much different from usual osteochondrosis.
The typical signs of erythrodermic psoriasis are red areas on the skin and increase of local and system temperature. Initially, the areas of erythema are localized regardless of papules and plaques, but later they merge and capture the entire skin. The symptoms include dry skin, flaking, and itching, as well as the increase of lymph nodes (lymphadenopathy). If the disease is of severe form, the internal organs are also affected. At the later stages, patients tend to significantly lose weight. Extensive trophic ulcers appear and because of bacony degeneration, one experiences kidney failure. The mild form of psoriasis can be almost asymptomatic, but it is often characterized by small areas of modified skin. The mild form combines the typical and atypical variants, as well as guttate psoriasis type.
This form of psoriasis makes up to 80 percent of all the cases of the disease itself. Therefore, it is considered the most widely spread one. The classical symptoms of plaque psoriasis are reddish spots that rise above the rest of the surface of the skin and are covered with a large number of silver-white scales. The psoriatic elements usually appear on extensor surfaces of the joints and the scalp.
Guttate psoriasis may affect a significant part of the body surface. Still, the typical place for this form of the disease to localize are the hips. The skin elements resemble small drops of red or purple color, which usually appear after or secondary to streptococcal infection.
Atypical Form of Psoriasis or Inverse Psoriasis
When people suffer from inverse psoriasis, psoriatic plaques appear on the flexor areas of the joints and skin folds (in contrast to typical forms of the disease when the plaques are concentrated on the extensor surface of the extremities and scalp).
Peculiarities of Psoriasis Localization
Often doctors wonder about the types of psoriasis depending on the localization of the pathological process. This is related to the fact that specific types of the disease are usually localized in the specific areas of the body. Quite often, this feature helps to identify the specific form of psoriasis and this determines the effectiveness of the assigned therapy. In this case, the disease causes and treatment are directly connected.
Hands and Legs
Types of psoriasis on hands vary and depend on the specific form of the disease. If it is a common form of the disease, bends of the elbow are usually affected. The typical white of silver scales appear in those areas. If we are talking about palmoplantar form of psoriasis, the palmar surfaces are affected. The skin gets less elastic and tougher due to the formation of a thick corneal layer. Atypical forms make psoriatic elements appear on flexor surfaces of the joints just like in atopic eczema. Due to the constant friction, psoriatic lesions are bright red and significantly raise above the unaffected skin. The types of psoriasis on feet are similar to symptoms of psoriasis on hands and usually appear at the same time.
Psoriasis on the entire body usually reveals when the process is generalized. As a rule, in this case, we speak of a typical form of the disease manifested as plaques which merge eventually. The disease more often affects the back and is less frequent on the abdomen. When this happens, both plaque and guttate skin elements appear together.
Human’s face is not a typical area for the disease lesions. Therefore, the number of psoriasis types on the face is quite limited. Usually, small papules of typical form appear which are located around the eyes, near the eyebrows, and in nasolabial folds.
Scalp psoriasis often includes a seborrheic form which affects the line on the forehead where hair doesn’t grow (also called psoriatic crown). Skin elements eventually mass and spread over the entire surface and look like dandruff. This localization is quite common and occurs in about half of the cases. Psoriasis is much less frequent in the ears. Usually, it is provoked by depressed immune system function or metabolic disorders.
Various types of nail psoriasis (onychodystrophy) cause a variety of damages to the distal phalanges. This basically changes the color of the nail plate, its structure and consistency. The nails become brittle and even begin to crumble (as in fungal infection). Onychodystrophy reaches its highest point when the nail plate completely dissolves (onycholysis).
There is no classification of psoriasis depending on the time of the year. Still, very often the health condition of the patients gets worse in certain weather conditions. In case one cannot trace the connection clearly it means we deal with an all-season type of the disease. Summer form of psoriasis is very sensitive to sunlight, so the periods of aggravation usually happen in this season. Winter form of psoriasis is more common. It is provoked by the cold.
Unfortunately, there is no way to cure the disease completely. Methods of treatment can vary greatly depending on the particular type of disease. For example, doctors can treat the winter type of psoriasis with ultraviolet irradiation. This will immediately lead to an exacerbation of the summer type disease. That is why the kind of psoriasis and its treatment should be identified by the doctor.
It must be mentioned that psoriasis is a very widespread disease that affects people of any ages and gender. Male and female gender is equal when talking about the probability of getting sick. The disease occurs in women, men, and in children, but the scientists have noticed that it is usually revealed in young patients. Self-diagnosis and self-medication can put your life at risk or lead to worsening of symptoms. You should better consult a reliable and experienced dermatologist to treat the disease.