Symptoms of Psoriasis

by Edward F. Group III, DC, ND, DACBN
updated on 04/28/2006 at 05:11PM

The classic symptoms of psoriasis includes swollen, red patches of skin, or lesions, that are covered with loose, silvery scales. Psoriasis most frequently occurs on the knees and elbows, although it can appear on the skin anywhere throughout the body. The most common symptoms of psoriasis include:

Plaques: Plaques are elevated or swollen areas of skin. They can vary in size from one centimeter to several centimeters. Some people experience only a few plaques at a time, while others develop many plaques all at once. Plaques are usually oval in shape but they may be irregularly shaped as well. Occasionally, several smaller plaques may merge together to form one large affected area. Plaques sometimes have an area around them that looks like a halo or ring. This is known as the Ring of Woronoff. Plaques can occur anywhere, but commonly they occur on the knees, elbows, scalp, hands, feet, or lower back.
Bleeding: The skin in the affected area may become so dry that is begins to crack and bleed. In addition, tiny areas of bleeding may develop when skin scales are picked or scraped off. This is known as Auspitz's sign.
Scales: Psoriasis is characterized by loose scales that cover the affected area. These scales are typically dry, thin, and silvery-white. The thickness of the scales may vary from a mild case to a thick crust of scales. When the scales are removed, the skin underneath is usually red, smooth, and glossy.
Itching: Psoriasis lesions or plaques commonly itch, especially when they develop suddenly, or when they occur in flexural areas of the body such as under the breasts or the buttocks.
Redness: Skin that is affected by psoriasis is typically a very distinctive salmon-red color. Occasionally, when psoriasis occurs on the legs, the skin may appear to have a blue tint.
Symmetry: Psoriatic plaques or lesions tend to appear on both sides of the body in the same places. This is known as symmetry. For instance, psoriasis will usually develop on both knees or both elbows at the same time.
Nail Disorders: Studies show that approximately fifty percent of people with psoriasis also develop nail disorders. Symptoms of nail disorders include pitting; yellowish discoloration; a buildup of skin debris under the nails; or a separation of the end of the nail from the nail bed.
Scalp: Some people who develop psoriasis will have dry, scaly skin or crusted plaque areas on their scalp. Scalp psoriasis is often confused with seborrheic dermatitis. However, the scales of scalp psoriasis are silvery and dry compared to the yellowish, greasy scales of seborrheic dermatitis.
Other Symptoms: Psoriasis most common affects the arms, leg, back, and scalp however the condition can actually occur on any body part. Psoriasis can also be found on the genitals or buttocks, under the breasts, or under the arms, causing extreme sensitivity, itching, and burning.

Symptoms in Children

Plaque psoriasis looks slightly different in children compared to adults. Children tend to develop plaques that are not quite as thick and scaly as those found on adults. Psoriasis can develop in the diaper region in young babies and toddlers, and in the folds of skin children. In addition, psoriasis occurs more commonly on the face in children than it does in adults.

There are several types of psoriasis, and each of these is associated with its own unique set of symptoms. The symptoms for each type of psoriasis may vary in duration and severity.

Plaque Psoriasis: Plaque psoriasis is the most common type of psoriasis. It is characterized by skin lesions that are red at the base and covered by silvery scales. Approximately ninety percent of people who suffer from psoriasis have plaque psoriasis.
Guttate Psoriasis: Guttate psoriasis is thought to be triggered by an upper respiratory infection such as strep throat. The condition causes small, drop-shaped lesions that typically appear on the trunk, limbs, and scalp. Guttate psoriasis often clears up only to recur as plaque psoriasis.
Pustular Psoriasis: In rare cases, the patches of dry, scaly skin can crack and have pus on top of them. These blisters of noninfectious pus are characteristic of pustular psoriasis. This condition may be triggered by an infection, stress, or a reaction to certain medications or chemicals.
Inverse Psoriasis: Inverse psoriasis develops as the result of friction of excessive rubbing on the skin. Smooth, red patches of skin generally occur in the folds of the skin near the genitals, under the breasts, or in the armpits. Sweating may worsen the symptoms of inverse psoriasis.
Erythrodermic Psoriasis: A severe skin reaction to a sunburn or to certain medications may cause the development of erythrodermic psoriasis. This type of psoriasis is characterized by widespread reddening and scaling of the skin.
Psoriatic Arthritis: Psoriatic arthritis is characterized by inflammation and pain in the joints as well as on the skin.