Different types of psoriasis

Psoriasis reveals itself in many ways. The following are the most common
varieties.
Common plaque (patch) psoriasis
Common psoriasis, also known as psoriasis vulgaris, is by far the most common
type of psoriasis, accounting for 80–90% of all psoriasis patients. It appears as
raised red scaling patches. The scales, which are often silvery and thickened,
appear most frequently on the elbows, knees, scalp and lower back. Figure 2
shows a typical elbow patch. However, all parts of the skin may occasionally be
subject to psoriasis.
Guttate psoriasis
This type of psoriasis often starts in childhood or teenage years, with the sudden
onset of small, raindrop-like patches of scaling skin (‘guttate’), much thinner
than plaque psoriasis. Often a sore throat caused by streptococcal infection will
prompt the appearance of guttate psoriasis. (See Case Study 2 of Lillian as an
example.)
Guttate psoriasis
(see Figure 3) often covers large parts of the body, but it
responds rapidly to ultraviolet therapy and some other forms of treatment. It can
also clear up, leaving the patient free of further outbreaks of guttate psoriasis. In
such cases, localized patches or plaques of psoriasis may develop later in life.
Skin-fold, ‘flexural’ and genital psoriasis
This type of psoriasis occurs in the skin-folds or flexures and can cause great
discomfort when one part of the skin rubs against another. This discomfort can
be so severe as to become disabling for the patient. It can occur in genital areas,
which can lead to discomfort and difficulties with sexual relations. It is more
common and troublesome in overweight patients.
Erythrodermic or exfoliative psoriasis
When psoriasis completely covers the body, it is known as erythrodermic,
exfoliative psoriasis or generalized psoriasis. Because such a large area of skin is
involved, patients may feel extreme discomfort. Patients may also encounter
problems controlling their body temperature, particularly in very hot or very cold
climates. Older people, particularly those with heart disease and heart failure, can
also develop problems from accelerated heart rate due to increased blood supply
flowing through the severely inflamed skin. This may lead to heart failure.