PSORIASIS – Types, Causes, Symptoms and Treatment

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Psoriasis is a common chronic inflammatory dermatological disorder. Mild to severe itching is a common symptom. Silvery Scales with plaques are found in this skin disease. Genetic factors also play a great role in the pathogenesis of Psoriasis. It sometimes goes into remission and sometimes flares up.


  • Obesity
  • Family history of Psoriasis
  • Bacterial or viral Psoriasis
  • Psychological factor or stress factor
  • Smoking


While the fundamental cause of psoriasis arises from the immune mechanism of your body, some causes can create symptoms worse or trigger flare-ups. These causes for psoriasis include:

  • SMOKING – Some specialists believe that smoking can worsen the signs of psoriasis.
  • ALCOHOL – Alcohol may increase the chances of Psoriasis.
  • COLD AND DRY WEATHER – In comparison warmer, the sunny climate seems to assist the signs of Psoriasis in most individuals. Such climate can dry your skin which makes the probability of flare-up worse.
  • MENTAL PRESSURE – Psoriasis can trigger pressure on its own, and patients often report that symptoms outbreaks occur during moments of particular pressure.
  • SKIN TRAUMA – Recurrent skin trauma like Tattoos, Piercings, and skin cut can trigger Psoriasis.
  • MEDICATION – Some drugs like ACE inhibitors, Beta-blockers, Lithium, Tetracycline, anti-malaria drugs like Quinine, NSAIDs also flare up Psoriasis.


Symptoms of Psoriasis varies from person to person. It may be asymptomatic or mild-severe itching may be seen well-demarcated red plaques with silvery scales are common findings. The most common sites are Scalp, Elbow, Knee, Palms, and Soles. Nail pitting and onycholysis are found.


  • PLAQUE PSORIASIS – The most common type of Psoriasis is Plaque Psoriasis. It is also known as Psoriasis Vulgaris. Dry, silvery Scale with raised plaque found in the skin. HLA-CW6 is often associated with it. It may be itchy or painful.
  • PUSTULAR PSORIASIS – Noninfectious pus-filled blisters are seen. Most commonly in hand, feet, and fingertips. This is painful. Sometimes generalized pustular Psoriasis is found which is associated with fever.
  • GUTTATE PSORIASIS – Drop-shaped lesion with fine-scale is the hallmark. Children and young adults often suffer from guttate Psoriasis. Bacterial infection acts as a trigger factor.
  • ERYTHRODERMIC PSORIASIS – Here, red rashes with itching or burning sensation found.
  • INVERSE PSORIASIS – It affects the folds of skin, commonly involved areas are armpits, below the breast, skin fold around genitals and between the buttocks. It may cause cracks within the skin and it is painful.


Dermatologists diagnose it through clinical examination and case history. Skin biopsy is needed where the diagnosis is uncertain.


Highly potent topical corticosteroid ointments are used when <10% of body surface area affected. Calcitriol (vitamin D analog) 0.003% is also used along with topical steroids but must be used at a different time. Other topical treatments include 6% Salicylic acid, P and S solution or emollient cream. 0.1% Tacrolimus ointment and 1% Pimecrolimus cream are also found useful for Psoriasis treatment.


Almost 30% of Psoriasis patients suffer from specific non-erosive arthritis known as psoriatic arthritis. It is a type of polyarthritis involving unilateral or bilateral joints. Joints are painful and swollen, stiff, often resemble Rheumatoid Arthritis. Sausage shaped fingers and toes are characteristic of psoriatic arthritis. Abnormal immunomodulation causes inflammation in joints, but no joint erosion. It may cause low back pain due to Sacroiliitis. Psoriatic Arthritis is a type of Seronegative spondyloarthropathies commonly involved joints are hand, feet, knees, ankles and spine. Psoriatic arthritis patients may develop tendonitis (inflammation of tendon) or enthesitis (inflammation of entheses)

Treatments of Psoriatic arthritis include NSAIDs, DMARDs, and exercise. NSAIDs give symptomatic relief from joint pain. Exercise must be done regularly to prevent joint deformity. DMARDS (Disease Modifying Anti Rheumatoid Drugs) are very effective in this disease as they prevent joint destruction as well as joint deformity. Sulfasalazine, Hydroxychloroquine, Methotrexate are commonly used in DMARDS.

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