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Making the Best Choices for Your Psoriasis

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Signs of a Psoriasis Flare

Medically Reviewed By William C. Lloyd III, MD, FACS

If you've had psoriasis for some time, you may instantly recognize the signs of a psoriasis flare-up. But if you were diagnosed more recently, you may not be aware of the warning flags and early symptoms.

You should also know that there are five types of psoriasis, and it is possible for the type you have to change. In some people, one type clears up and another emerges.

Here are the five types of psoriasis and how to recognize them and spot flare-ups.

1. Plaque Psoriasis 

Plaque psoriasis is the most common type of psoriasis—it affects about 80 percent of psoriasis sufferers. In the early stages of plaque psoriasis, you might not see any outward signs, but you may be aware of an itching or burning sensation. As the outbreak occurs, you'll see small red bumps that eventually grow into inflamed lesions. The lesions become covered with a thick buildup of skin cells that form silvery-white scales. Typically these lesions, commonly called plaques, erupt on the elbows, knees, scalp, and lower back.

2. Guttate Psoriasis

Guttate psoriasis, also known as "drop" psoriasis, most often affects children and young adults. Unlike plaque psoriasis, in which the lesions cover entire areas of skin, guttate lesions are individual red eruptions that can be widespread across the torso and the limbs. This type of psoriasis can appear suddenly and be brought on by a number of other medical conditions, including upper respiratory infections, streptococcal throat infections (strep throat), tonsillitis, stress, or an injury to the skin. Antimalaria drugs and beta blockers can also trigger this type of psoriasis.

3. Inverse Psoriasis

Inverse psoriasis usually forms in skin folds, like in the armpits, under the breasts, in the groin area, and in other folds around the genitals and the buttocks. This type of psoriasis involves bright red, smooth, shiny lesions. Because of their location, the psoriasis patches can be further irritated by friction and perspiration. They can be tender, but typically the patches do not form scales. This type occurs more commonly in people who are overweight.

4. Pustular Psoriasis

The very first signs of pustular psoriasis are actually areas of red skin. Its tell-tale small, white blisters come next. The blisters fill with pus but they are not infectious. You'll also see scaling and may feel like you have the flu with aches and pains and fatigue. This type of psoriasis can affect your entire body or be localized on the hands and feet or even just the palms and soles, for instance. Triggers can vary from medications to sunburn.

5. Erythrodermic Psoriasis

Erythrodermic psoriasis first appears as fiery-red skin. It can extend from head to toe. The next stage is what makes this psoriasis so dangerous: Skin peels off in sheets, rather than flakes, and loses its function as a protective barrier—making the body more susceptible to infection and severe fluid loss. This type of psoriasis itches badly and can also be accompanied by a fast heart rate and fever. If you develop this type of psoriasis, you must contact your doctor immediately, as it can be life threatening. Fortunately, this type of psoriasis is rare.

No matter what type of psoriasis you have, be aware that it can surface anywhere. Psoriasis often occurs on the large parts of the body, but it can also affect the eyelids, ears, mouth and lips, skin folds, hands and feet, and nails. Treatment varies based on the body parts affected. If you develop a different type of psoriasis or if psoriasis develops in a new area, contact your doctor. 

Was this helpful?
  1. Psoriasis on Specific Locations. National Psoriasis Foundation.
  2. Types of Psoriasis. National Psoriasis Foundation.
  3. What Psoriasis Looks Like. PsoriasisNet, American Academy of Dermatology.
Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2021 May 19
View All Making the Best Choices for Your Psoriasis Articles
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