Inverse psoriasis is a type of psoriasis that occurs in the armpits, under the breasts, groin, genitals, in the crease between the thigh and groin, and other skin folds.
Diagnosis of inverse psoriasis is typically based on medical history and a clinical examination that assesses the location and appearance of the rash.
In some cases, especially when rashes appear as the only manifestation of the disease, other diagnostic methods that can be used include:
- Skin biopsy or histopathology: This involves taking a sample of the affected skin and examining it under the microscope. Inverse psoriasis may present with the classical histopathological findings of plaque psoriasis (epidermal hyperplasia and elongation of rete ridges with acanthosis, parakeratosis, thinning of the suprapapillary plates, and reduction of the granulosus layer). However, epidermal hyperplasia is less pronounced, and spongiosis is more common in inverse psoriasis compared to classical plaque psoriasis.
- Dermoscopy: This may show the characteristic presence of whitish scales and red dots homogeneously distributed within the entire plaque.
- Reflectance confocal microscopy (RCM): Although currently available only in some selected academic centers due to the high cost, this is a noninvasive technique that is useful for the differential diagnosis of other inflammatory genital disorders.
What causes inverse psoriasis?
It is estimated that psoriasis affects about 2% of the population, approximately 3%-7% of whom develop inverse psoriasis.
The exact cause of inverse psoriasis is unknown. However, experts believe that it is associated with an overreaction of the immune system that triggers inflammation and exaggerated new skin cell growth.
Inverse psoriasis often runs in families, indicating a genetic trigger. A flare-up of inverse psoriasis can be caused by:
- Skin injuries
- Streptococcal infections
- Injuries, such as injections, sunburn, or a scratch
- Larger skin folds due to obesity
- Excessive perspiration
- Certain prescription medications
How does inverse psoriasis affect the body?
Rashes associated with inverse psoriasis are often damp, shiny, smooth, and discolored (brown, red, or purple).
The main difference between psoriasis and inverse psoriasis is that inverse psoriasis does not feature thick, scaly plaques like other types of psoriasis. This is most likely because of its presence in the moist areas of the body.
The condition commonly affects moist and sensitive areas of the skin that rub against each other, such as:
- Crease of neck
- Skin folds around the genitals and between the buttocks
- Under the breasts
- Between the abdominal folds
- In the groin or inner thighs
- Around the penis, scrotum, or vulva
These lesions can cause painful and bleeding cracks (fissures) in the creases of the skin, as well as:
- Irritation and itching from rubbing and sweating
- Bacterial, yeast, and fungal infections
- Sexual problems due to pain and discomfort
What are the symptoms of inverse psoriasis?
Symptoms of inverse psoriasis include:
- Shiny, smooth, discolored (brown, pink, purple, or red) rash
- Cracks (fissures) in creases of the skin
- Itching and irritation
- Moist skin
If the rash is infected, symptoms may include:
What are complications of inverse psoriasis?
Complications of inverse psoriasis include:
- Irritation due to sweating
- Secondary fungal or yeast infections, especially Candida albicans
- Lichenification (thickening of the skin) from rubbing and scratching, specifically around the anus
- Sexual difficulties (due to embarrassment and discomfort)
- Thin and discolored skin from the long-term overuse of strong topical steroid creams
- Kids With Autism Face Higher Odds of Vision Issues, But Many Don't Get Screened
- Mental Health Woes Double Women's Odds for Cervical Cancer
- Million-Person Study Finds Genes Common to Many Addiction Disorders
- Too Much Social Media Could Raise Risk for Eating Disorders
- Weaker Bones, Weakening Brain? Study Makes the Connection
- More Health News »
Health Solutions From Our Sponsors
WebMD. Inverse Psoriasis. https://www.webmd.com/skin-problems-and-treatments/psoriasis/inverse-psoriasis
Cleveland Clinic. Inverse Psoriasis. https://my.clevelandclinic.org/health/diseases/22852-inverse-psoriasis
National Psoriasis Foundation. Inverse Psoriasis. https://www.psoriasis.org/inverse-psoriasis/
Micali G, Verzì AE, Giuffrida G, Panebianco E, Musumeci ML, Lacarrubba F. Inverse Psoriasis: From Diagnosis to Current Treatment Options. Clin Cosmet Investig Dermatol. 2019;12:953-959. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6997231/
Top How Is Inverse Psoriasis Diagnosed Related Articles
Can Psoriasis Go Away?Psoriasis is a skin disease that develops due to changes in genetic makeup, and most often, it is passed from your parents (hereditary). It may also occur due to changes in the immune system, autoimmune response, in which your own antibodies start attacking the cells of your body. Psoriasis is a chronic inflammatory condition that has no definite cure and only the symptoms can be managed.
Can You Put Tacrolimus on Genitals?Tacrolimus is a topical treatment for psoriasis that can be used on sensitive areas of the body, including the genitals, face, neck, and skin folds.
Does Psoriasis Have a Smell?There are several types of psoriasis and none of the types have any smell. If you notice an odor from your psoriasis, it is possible that there is a secondary bacterial or fungal infection on the affected skin.
How Do You Manage Inverse Psoriasis?Although there is no permanent cure for inverse psoriasis, treatment can help manage and alleviate symptoms, including itching and discoloration.
Psoriasis Picture 1A reddish, scaly rash often located over the surfaces of the elbows, knees, scalp, and around or in the ears, navel, genitals or buttocks. See a picture of Psoriasis and learn more about the health topic.
Severe Psoriasis PicturesExplore the different types of psoriasis such as plaque psoriasis, inverse psoriasis, and scalp psoriasis. Discover what causes psoriasis and many psoriasis treatment options.
Psoriasis Home RemediesDiscover home remedies for psoriasis and help heal irritated skin.
Psoriasis QuizTake the mystery out of psoriasis. Take the Psoriasis Quiz and see what you know about the types, symptoms, treatments and more.
Psoriasis SlideshowWhat is psoriasis? See examples of psoriasis including the different types of nail, plaque, and scalp psoriasis. Learn about psoriasis symptoms, causes and treatment.
tacrolimus (Prograf, Astagraf XL, Envarsus XR)Tacrolimus (Prograf, Astagraf XL, Envarsus XR) is a medication prescribed for the prevention of rejection of transplanted liver, heart, or kidneys. Side effects may include nausea, vomiting, itching, fever, tremor, headache, baldness, anemia, rash, and abdominal pain. Drug interactions, dosing, and pregnancy and breastfeeding safety information should be reviewed prior to taking this medication. The brand Hecoria has been discontinued in the US.
tacrolimus ointment (Protopic)
Tacrolimus ointment (Protopic) is a medication prescribed for the treatment of moderate to severe atopic dermatitis, in children and adults who have normal immune systems, and have not responded to other topical treatments. Side effects, dosage, and drug interactions should be reviewed prior to using this medication.
What Is the Best Treatment for Psoriasis?
Psoriasis is an incurable chronic autoimmune disorder of the skin that causes patches of thick, flaky, scaly skin, mostly around the scalp, knees, and elbows, though any skin surface may be involved. Some people experience only small patches while others have red, inflamed skin and think scaly patches all over the body. The exact cause of psoriasis is not clear, but it isn’t contagious.
What Are the Levels of Psoriasis? TypesLearn the three levels of psoriasis, as well as the five different types, which each include their own symptoms, causes, and triggers.
What Is the Main Cause of Psoriasis?Psoriasis is a non-contagious skin disease in which the skin cells grow in numbers faster than normal, producing rashes on the body. Normally, the cells on the surface of the skin are shed as new cells grow beneath. In psoriasis, the swift build-up of skin cells collects on the surface of the skin as scales or plaques. The exact cause of psoriasis is not completely understood. It appears to involve an interplay between a person’s genes, immune system and environment.
Where Does Psoriasis Usually Start?The most common sites of psoriasis are the scalp, elbows, and knees, although psoriasis can involve any part of the body such as the face, palms, soles, and back.