Psoriasis is a non-contagious, lifelong skin disease. As many as 7 million Americans have some form of psoriasis. The most common form is called plaque psoriasis appears as raised, red patches or lesions covered with a silvery white buildup of dead skin cells called scale. There are five main types of psoriasis including plaque, guttate, inverse, pustular, and erythrodermic. Guttate psoriasis appears as mall red dots on the skin whereas inverse psoriasis occurs in the armpits, groin, and folds of skin. Pustular psoriasis has white blisters that is surrounded by red skin. The least common and worst kind of psoriasis is erythrodermic psoriasis which causes intense redness over large areas of the body.
Psoriasis can occur on any part of the body, including the scalp, genitals, around the ears, eyes, mouth, and nose plus on the hands and feet. Psoriasis of the nails is also considerably common. Nail changes occur in up to 50% of people with psoriasis and at least 80% of people with psoriatic arthritis. The nail problems most commonly experienced by psoriasis patients are pitting which causes shallow or deep holes in the nail. Deformation causes alterations in the normal shape of the nail plus thickening of the nail. Separation of the nail from the nail bed, also called onycholysis, may occur plus unusual nail coloration such as yellow-brown. Because psoriasis affects the nail while it’s being formed, it is difficult to treat. The matrix, where the nail is formed, is difficult to penetrate with topical medications. Injections of steroids into the nail bed or matrix area have been used with varying results. The pain of the injections must be weighed along with the possibility of the relief being only temporary.
Acute flares of psoriasis on the hands and feet need to be treated promptly and carefully. In some cases flares are accompanied by cracking, swelling, and blisters. General treatments include the use of moisturizers, mild soaps, and soap substitutes. Traditional topical treatments of palm and sole psoriasis includes tar, salicylic acid, and steroids. Combinations of these three agents may be superior to each one used individually. It may be necessary to find additional ways to reduce built-up layers of skin in order for medications and phototherapy to be effective.
Scalp psoriasis is very common. At least half of all people who have psoriasis have it on their scalp. As with psoriasis elsewhere on the body, skin cells grow too quickly on the scalp which causes red lesions covered with scale to appear. Scalp psoriasis can be very mild, with slight, fine scaling. It can also be very severe with thick and crusted plaques which cover the entire scalp. This can cause hair loss. Psoriasis can extend beyond the hairline onto the forehead, the back of the neck, and around the ears. Most of the time, people with scalp psoriasis have psoriasis on other parts of their body as well. However, for some the scalp is the only affected area. Other skin disorders, such as seborrhea dermatitis, may look similar to psoriasis, but there are several differences. Scalp psoriasis scales appear powdery with a silvery sheen.