Psoriasis - Symptoms

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What are psoriasis symptoms and signs? What does psoriasis look like?

Psoriasis appears as red or pink small scaly bumps that merge into plaques of raised skin. It classically affects skin over the elbows, knees, and scalp and is often itchy. Although any area may be involved, it tends to be more common at sites of friction, scratching, or abrasion. Sometimes pulling off one of these small dry white flakes of skin causes a tiny blood spot on the skin. This is medically referred to as a special diagnostic sign in psoriasis called the Auspitz sign.

Finger and toenails often exhibit small pits (pinpoint depressions) and/or larger yellowish-brown separations of the nail from the nail bed at the tip called distal onycholysis. Nail psoriasis may be confused with and incorrectly diagnosed as a fungal nail infection.

Symptoms and signs of guttate psoriasis include bumps or small plaques (½ inch or less) of red itchy, scaling skin that may be present over large parts of the skin surface. This condition often is preceded by a sore throat and appears all at once.

In inverse psoriasis, genital lesions, especially in the groin and on the head of the penis, are common. Psoriasis in moist areas like the navel or the area between the buttocks (intergluteal folds) may look like flat red plaques without much scaling. This may be confused with other skin conditions like fungal infections, yeast infections, skin irritation, or bacterial infections.

Symptoms and signs of pustular psoriasis include at rapid onset of groups of small bumps filled with pus on the torso. Patients are often systemically ill and have a fever.

Erythrodermic psoriasis appears as extensive areas of red skin often involving the entire skin surface. Patients may often feel chilled.

Nail psoriasis appears as pits and a yellowish to whitish discoloration at the tip of one or more of the toenails or fingernails. In severe disease, the nails may be brittle and fall apart.

Scalp psoriasis may look like severe dandruff with dry flakes and red areas of skin. It may be difficult to differentiate between scalp psoriasis and seborrheic dermatitis when only the scalp is involved. However, the treatment is often very similar for both conditions.

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See what others are saying

Comment from: JP, 45-54 Male (Patient) Published: December 01

I had psoriasis for 20 years. After all the useless preventative treatments and excessive costs, I used Enbrel for a few years until I couldn't afford it anymore. Even with insurance, I would have to pay a large deductible ($2,500 to $4,000), and after satisfying deductibles, insurance would pay only $100 maximum for continued treatments, leaving me with an additional copay of $100. I'm glad to have health insurance, but psoriasis requires 'specialty' medications/treatment and a lot of money! I'm waiting for 2015 to start treatment again. I believe anxiety/stress worsens my psoriasis. It's a cyclical pattern, and when it's bad, I pick, scratch, and even scrape with a knife until it bleeds. The itching is insatiable! I use Medicated Gold Bond to relieve the itching temporarily. My doctor recently prescribed clobetasol, and 0.5/zinc spray; I've had some relief as I did with ointments such as clobetasol and halobetasol and yes, the skin gets used to these after a while. One side effect of Enbrel, I believe, leads to thinning of the skin where minor cuts or scrapes can cause bruising/excessive bleeding.

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Comment from: KT, 25-34 Female (Patient) Published: June 04

I was diagnosed with guttate psoriasis at age 24 after a severe strep throat infection. It took 5 doctors to determine what it was and then 2 more doctors before there was any relief. This resulted in 10 months of being covered in lesions on every part of my body. Nothing topical worked (both prescription or over-the-counter) and nothing relieved the itching. The dermatologist eventually told me to make a choice; increased risk of skin cancer or psoriasis. I choose the increased risk of skin cancer and began lying in the sun covered in baby oil every day for 20 minutes. It cleared within a month! Six years later and I am suddenly covered in guttate psoriasis again. Unfortunately, the sun is not helping this time so I'm back to square 1 but at least I know what is wrong with me this time!

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