Symptoms of Psoriasis

Individuals with psoriasis experience symptoms such as itching, cracking, stinging, burning, or bleeding (ICN Pharmaceuticals, Inc.). Lack of sunlight and low indoor humidity in the winter months can cause the psoriasis symptoms to worsen (Hall 132). The skin is most likely to crack at the joints where the body bends, or in areas where the individual scratches. Scratching should be strictly avoided, because it can cause bleeding and infection. Psoriasis has also been known to cause pits or dents to form in fingernails and toenails. There is also the possibility that the soft tissue inside the mouth and genitalia can be affected. In some cases, psoriasis will cause joint inflammation that produces arthritis symptoms. This condition is called psoriatic arthritis.

People with psoriasis may notice that there are times when their skin worsens, then improves. Conditions that may cause flareups include changes in climate, infections, stress, and dry skin. Also, certain medicines, most notably beta-blockers, which are used in the treatment of high blood pressure, and lithium or drugs used in the treatment of depression, may cause an outbreak or worsening of the disease.

Causes of Psoriasis

There are many beliefs as to the cause of psoriasis. Although no one knows for sure, many scientists believe that a biochemical stimulus triggers the abnormally high skin growth which will in turn cause the skin lesions (National Psoriasis Foundation). Heredity also plays a role in the development of psoriasis. Individuals who have a family member with a severe case of psoriasis tend to experience early onset of the disease (Camisa 55). Recent research studies indicate that psoriasis may be a disorder of the immune system. The T cell, a white blood cell, normally works to fight off infection and disease. Scientists believe that having an abnormal immune system may cause abnormal activity by T cells in the skin. These abnormally active T cells cause skin inflammation and increased cell production. Diet and vitamin influences are thought to play a role in psoriasis development and progression (Kligman 729).

Because psoriasis is a lifelong condition, the levels of its severity and improvement can fluctuate over time. Psoriasis is not a contagious skin condition. Instead, an individual has a genetic predisposition for psoriasis, which can be activated by certain environmental factors or emotional stress. Individuals with psoriasis may find that their condition tends to flare up due to stress, certain medications, winter weather, and infections (ICN Pharmaceuticals, Inc.). Most often psoriasis affects the scalp, knees, elbows, hands, and feet (National Psoriasis Foundation).

Forms of Psoriasis

Plaque-type psoriasis is the most common form of the disease and is commonly referred to as psoriasis vulgaris (Camisa 56). Plaque-type psoriasis is characterized by inflamed skin lesions topped with silvery white scales. This type of psoriasis can assume many different appearances based on its location, the activity of the disease, and the treatment being administered. Plaque-type psoriasis is most commonly found on the elbows, knees, scalp, sacrum, umbilicus, intergluteal cleft, and genitalia (Camisa 56).

Guttate psoriasis is characterized by small dot-like lesions. Guttate psoriasis is the most common cause of psoriasis in children and young adults who have a prior history of upper respiratory infection, pharyngitis, or tonsillitis (Camisa 64). The lesions are not as scaly as plaque-type psoriasis and are likely to be found on the trunk and involve the face (Camisa 64).

Pustular psoriasis is characterized by pustules, which are blister-like lesions of non-infectious fluid, and cause intense scaling. Individuals with pustular psoriasis are often among the most seriously ill and may have to be hospitalized (Camisa 67).

Erythrodermic psoriasis is the rarest form of psoriasis and is characterized by intense redness and swelling, exfoliation of dead skin, and pain. Erythrodermic psoriasis usually develops during the course of chronic psoriasis. However, in some cases erythrodermic psoriasis is the first manifestation of psoriasis, even in children (Camisa 74). Individuals with this type of psoriasis may experience chills and low grade fever, and may be rather uncomfortable (Camisa 75).

Inverse psoriasis is characterized by smooth inflamed lesions in the body folds -- armpits, under the breast, skin folds of the groin, buttocks, and genitals.

Koebner's Phenomenon psoriasis are psoriatic lesions which appear at the site of injury, infection or other skin psoriasis, or may be a new lesion in an existing case.

The degree of psoriasis can also vary from individual to individual. It ranges in severity from mild (affects less than 2% of body) to moderate (affects 2-10% of body) to severe (affects greater than 10% of the body). Skin injury and irritation, sun exposure, diet, stress and anxiety, medications, and infections have been known to make psoriasis worse.

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SEBORRHEIC SCALP PSORIASIS

The scalp may be the first site on the body to be affected by psoriasis. Psoriasis that affects the scalp is called Seborrheic scalp psoriasis. Psoriasis on the scalp is common and, in many cases, it is the only area affected. Seborrheic scalp psoriasis usually consists of red, scaly patches that may appear lumpy. The edges of these patches tend to be well defined. Seborrheic scalp psoriasis can extend beyond the hairline, onto the forehead. Psoriasis of the scalp does not damage the hair follicle and is not associated with hair loss, but if the scale is thick and forms hard lumps, it may lead to temporary hair thinning.

Scalp psoriasis can be very mild, with slight, fine scaling. It can also be very severe with thick, crusted plaques covering the entire scalp. Seborrheic scalp psoriasis can be extremely uncomfortable. It is often very itchy, and the psoriatic patches that are inflamed and sore can start to bleed if they are scratched or picked. Seborrheic scalp psoriasis is not caused by poor hygiene or hair care. Itchiness can inflame and irritate the condition.

Seborrheic scalp psoriasis may resemble severe dandruff. Patches of thick, flaky skin may extend to the forehead below the hairline. Scales may build up in the outer ear. The face itself is usually unaffected; this is an important feature in diagnosis due to the fact that with rosacea you can have episodes of seborrheic dermatitis. Approximately 35% of people with rosacea have seborrheic dermatitis. Seborrheic dermatitis involves overactive sebaceous glands, which cause inflammation, flaking and a red rash in the central portion of the face. If one looks closely, the flakes usually have a greasy look, smell and feel. The dryness of seborrheic dermatitis is perceived because of the flaking, which consists of dried layers of accumulated oil. Seborrheic dermatitis causes yellowish scales to develop on the scalp, the hairline and the eyebrows. This is often confused with the crusting and scaling on the eyelids that occur with ocular rosacea.