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 fragile 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: tyzac, 55-64 Female (Patient) Published: March 28

I developed guttate psoriasis approximately 5 years ago, after seeing 2 skin specialists with reasonable results. About June last year it flared up into something awful on my legs, arms, hands, buttocks, back and scalp. I gave up my job as it involved contact with the public and off I went to another dermatologist. He just asked a few questions, had a look at the affected areas and immediately arranged for phototherapy treatment at the local hospital. What magic! After 21 sessions which ended on a 2 minute treatment, 95% of lesions disappeared. Now I just use Daivobet cream for body and gel for scalp when it looks like something maybe forming. I shampoo and condition with T-Gel alternating days with goat milk hair products. Needless to say, I am much happier these days.

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Comment from: joan b, 65-74 Female (Patient) Published: October 18

At age 18 I developed scales on elbow and knees. This lasted until age 65 and disappeared. Shortly after, I developed pustular psoriasis on the bottom of my left foot. If I take an antibiotic for a different reason it clears up but returns even worse when antibiotic is ended. It itches and is painful. My dermatologist has no remedy.

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