What Is Mild to Moderate Psoriasis?

The severity of plaque psoriasis varies with people.

Psoriasis may be classified depending on the extent of skin involvement into three types.

1. Mild psoriasis: Less than 3 percent of the BSA is affected.
2. Moderate psoriasis: 3 to 10 percent of the BSA is affected.
3. Severe psoriasis: More than 10 percent of the BSA is affected.

The cause of psoriasis is unknown. Researchers believe it could be a combination of things.

• Psoriasis is an autoimmune condition. The immune system that normally attacks infectious germs begins to attack healthy cells, causing skin lesions and plaques.
• In psoriasis, the skin cells multiply about 10 times faster than normal, which causes the skin to build up into bumpy red patches covered with white or silvery scales.

1. Plaque psoriasis or psoriasis vulgaris
   • This affects up to 80 percent of those with psoriasis.
   • Plaques can appear anywhere on the body as raised patches of inflamed, itchy, and painful skin with shiny white scales that can break and bleed at times.
2. Guttate psoriasis
   • This type affects roughly eight percent (second most common) of people with psoriasis and often, begins in childhood or young adulthood.
   • This type causes small, pink-red individual spots on the skin that appear on the trunk, upper arms, thighs, or scalp.
3. Inverse psoriasis or intertriginous psoriasis
   • It affects one-quarter of people living with psoriasis characterized by red or discolored lesions, especially in skin folds of the body that might appear smooth and shiny without scale formation.
   • This is usually seen in the armpits, crotch region, under the breasts, or other skin folds, such as those around the genitals and buttocks, and worsens with sweating and rubbing.
4. Pustular psoriasis
   • This is an uncommon type, affecting about three percent of people with psoriasis.
   • The formation of pustules (white, pus-filled, painful bumps) and scaling is followed by the discoloration of the skin, affecting specific parts of the body, such as the hands and feet, or can be present more generally over the body.
5. Erythrodermic psoriasis
   • A severe and rare type of psoriasis affects about two percent of people with psoriasis.
   • This type disrupts the skin barrier, causing protein and fluid loss and increased risk of infections that can lead to severe complications, such as pneumonia and congestive heart failure.

1. Psoriatic arthritis: Approximately 20 to 30 percent of individuals with psoriasis have joint inflammation with symptoms of arthritis.
2. Nail psoriasis: Approximately 50 percent of people with psoriasis have nail changes, including pitting of nails, discolored, tender and painful nails, and separation of the nail from the bed.
3. Impaired quality of life

Psoriasis is a chronic, long-lasting, and non-curable skin condition. However, the disease fluctuates, and many people can have remission (have clear skin for months or years) and occasional worsening of the condition (flare-ups).

Treatment relies on the type and severity of the condition.

1. Medications
   • Topical corticosteroids
   • Over-the-counter topicals
   • Oral medications, such as acitretin, apremilast, and methotrexate
   • Topical calcineurin inhibitors, such as Elidel (pimecrolimus) cream and Protopic (tacrolimus) ointment
   • Topical vitamin D analogs (calcipotriol, calcitriol)
   • Retinoid creams
   • Hydrocortisone creams
   • Salicylic acid
   • Coal tar
2. Biologic medications
   • These are protein-based drugs used as injections or infusions and made from living cells that target specific parts of the immune system.
     • Etanercept
     • Infliximab
     • Adalimumab
3. Phototherapy
   • This includes routinely exposing the skin to specific lights under clinical supervision that can help slow cell growth, suppress immune activity, and reduce irritation.
4. Others
   • Moisturizers for dry skin
   • Manage stress with yoga, exercise, and meditation
   • Consuming a well-balanced and nutritious diet
   • Recognizing and avoiding food triggers
   • Limiting smoking or alcohol
   • Prioritizing lean protein sources, such as chicken breast
   • Eating fish rich in omega-3 fatty acids
   • Avoid hot water baths; use lukewarm water
   • Use fragrance, dyes, and alcohol-free mild soaps or other products
   • Dry the skin gently after bathing