Plaque Psoriasis (psoriasis vulgaris): Plaque psoriasis occurs as crusty, red and dry patches of overgrown skin on the uppermost skin layer with a silvery white background comprised of dead skin tissues. This psoriasis is apparent on the scalp, knees, elbows and lower back. They produce itchy and painful scars on the area which often crack and start bleeding.
Flexural (Inverse): Although psoriasis maybe white in color, dark red lesions are often spread across different body parts, inverse psoriasis has very red lesions spurring up behind body folds, such as behind the knee, under the arm or in the groin. These lesions are shiny and smooth to touch.
Guttate Psoriasis: Guttate psoriasis has a small dot like appearance and the lesions appear mostly in children. These are small eruptions distanced quite apart in sequence that can turn into red marks. Young people or children are prone to Guttate psoriasis and prone to strep infection. There is about 10% of the population which gets guttate amongst psoriatic patients.
Pustular psoriasis: Pustular psoriasis is a form of noncontagious blisters that spread as white pustules having red boundary around them. These blisters are non-infectious having pus of white blood cells, but the pustules are non-infectious in nature. Although pustular psoriasis can occur in any area of the body but it is more pronounced on the hands and feet.
Erythrodermic psoriasis: Erythrodermic psoriasis is a particularly severe form of psoriasis that leads to widespread, fiery redness over most of the body. It can cause severe itching and pain, and make the skin come off in sheets. It is rare, occurring in 3 percent of people who have psoriasis during their life time. It generally appears in people who have unstable plaque psoriasis.
There are other types of psoriasis also the forms of which are given below:
Nail Psoriasis
The nail has a hard covering on top of the nail bed formed of keratin. When affected by psoriasis, the nail plate loses cells and it creates small pits on its surface that can grow in number, however, some nails could have the least pits while others have many. These pits vary from person to person that could be deep and shallow. It can also lead to nail plate separate from its bed which is called onycholysis leaving an space under your nail. There are hollow markings of white or yellow patch on the nail and thus infection may grow to form a dark color eventually. The nails could have coarse texture and lines and a thicker nail base. It can also turn a yellow-brown color. Crumbling nails show a white relief.
The treatment for nail psoriasis has different include options like topical corticosteroids to cleans the nail and injections to the affected nail. Psoralen lotion and ultraviolet light with other topicals do help. Avulsion and systemic therapy can be done in severe cases. Either phototherapy or removal of the nail is the last resort.
Pitting on nails is an important observation as in our clinical practice we have observed that psoriasis starts from skin after few years it effects nails and then if not treated properly can lead to joint pains or psoriasis arthritis.
Scalp Psoriasis
This is a common skin condition affecting the scalp and hair growth since the head is covered with thick, white patches of dry skin that makes a raised appearance, often scaly patches. This type of psoriasis can spread into a single patch covering the entire head or even form blisters and extend to the neck, behind the ears, forehead, and the back of your neck.
Even in case of scalp psoriasis, the immune system is the trigger. You are more likely to get scalp psoriasis if your ancestors had it.
The intensity of scalp psoriasis can be from mild to moderate but it can also be severe. A diseased scalp can have thick crusted sores leading to extreme itching and skin infections. There are red, bumpy patches on the head but burning causes soreness. Hair loss occurs if persistent hard scratching or picking at the scales continues although the hair grows back when the skin clears.
Genital Psoriasis
Genital psoriasis is psoriasis that develops around the genitals. It can generate on the vulva or the penis and extend to the upper thighs, skin folds, axillae, space between the gluteal or knees. However, internal vaginal area is unaffected. you can get flare-ups which are mainly triggered by stress related anxiety or illness.
Genital psoriasis can be directly linked with inverse psoriasis as this is the most common form which occurs in the folds of the skin. Psoriasis which looks to be thickened patches of skin has a different appearance in the genital area, with the patches being shinier and brighter red but the classic scale like identification is missing and yeast is visible.
Genital psoriasis also causes itching, burning, and discomfort. Sanitary products or any rubbing agent also aggravate symptoms including sexual intercourse but it is somewhat difficult to identify this infection. Fungal contagions could be the culprit which require a combination of treatments in a careful manner. Early intervention is great for treating this symptom. It doesn’t spread by sexual contact or affect fertility but still personal hygiene methods are necessary.
A good lifestyle measure like clean clothing, showering, avoiding harsh soaps, rubbing and tight fitting is mandatory.
Health and hygiene
If a person suffers with genital psoriasis, it’s likely that he is having irritation in his urine or faeces. Having a healthy diet and bathing in warm water to keep your hygiene clean is effective. Also tight clothing has the chance of rubbing the skin with them and aggravating this disease by friction. Protection is key. Proper cleaning after bowel movements is hygienic. A repeated injury can lead to a Koebner phenomenon, or a flare-up of psoriasis plaques, Using quality toilet paper, loose-fitting underwear, and using a fiber supplement can ease a flare-up. Wearing light and loose clothes will not only provide proper aeration around the body but also relieve you of excess sweating and bacterial infection. This condition can also get worse as a result of friction during sexual intercourse. Avoiding certain irritants can reduce a flare up. Using lubricants or a lubricated condom can help prevent a friction injury from sex. Keeping your partner about your health can further prevent this disease from exacerbating. Get your doctor’s advice before any drug therapy and you are on the safer side.
Causes and Triggers
The primary cause of psoriasis is toxins. These toxins are generated as usual in intestine and get disposed off through the normal channels of our body. When these channels gets blocked or toxins generation goes excessive then these toxins starts accumulating and expanding to different parts of body.
They get localized in and around genital and groin area.
Stress acts as a trigger and they appear as psoriasis in these effected areas.
In case of genital Psoriasis there is one more factor which needs to be kept in mind all the time.
The following are common triggers for genital psoriasis.
1. Tight Clothes which rub the skin
2. Contraceptives – sheaths
3. Caps and spermicides
4. Sanitary towels and tampons
5. Harsh toilet paper
6. Thrush or sexual intercourse
Emotional Factor
As we said earlier, Stress and stress like conditions are the main triggers for genital psoriasis. Therefore to keep the outbreak or flare up of genital psoriasis down, it is important to keep oneself stress free. Controlling the impact of emotional factor on body becomes the key in treating genital psoriasis as it becomes very difficult for patients to keep oneself stress free.
Diagnoses
In case of Genital Psoriasis, silver scaling is not visible which is the case for plaque. It is very important to have correct diagnosis and separate from other similar conditions of groin area.
Undiagnosed genital psoriasis in women may be mistaken for a yeast infection. A culture may be needed to rule out the yeast and other infections. It is equally important to rule out fungal infection before proceeding to treat psoriasis.
Redness and irritation in genital can also be there due to contact dermatitis. A biopsy may be required to correctly diagnose and separate psoriasis from other conditions.