Where Does Psoriasis Usually Start?

Psoriasis is a chronic skin condition that typically causes areas of thickened, scaly, red, and inflamed skin called plaques.

• Although psoriasis generally affects adults, it can occur in children and adolescents.
• Psoriasis is not transmitted from one person to another (noncontagious).
• Symptoms may vary depending on the severity and type of psoriasis.

The exact cause of psoriasis is unknown. Research suggests that the condition is caused by an overactive immune system in which the person’s immunity targets their skin instead of restricting itself to fighting diseases and infections.

• Excessive immune system activity leads to rapid growth and multiplication of skin cells.
• This proliferation is too fast for the body to compensate through shedding resulting in the piling up of cells and the formation of the typical plaques on the skin.

Moreover, genes may play a role in causing psoriasis. Certain conditions such as stress, injury, infections, dry skin, and some medications may play a role in causing psoriasis flare-ups.

Major types of psoriasis include:

• Plaque psoriasis: It is the most common type of psoriasis accounting for about 80 to 90 percent of the cases. It presents as typical psoriasis plaques with silvery scales. The plaques may vary in size, and the smaller ones may fuse to form larger plaques. Although it can occur anywhere, plaque psoriasis primarily affects the scalp, elbows, lower back, or knees.
• Guttate psoriasis: It is characterized by the sudden appearance of small, scaly, salmon to pink bumps on the skin mainly over the arms, torso, and legs. The lesions typically clear on their own in a few weeks to months. 
• Pustular psoriasis: As the name suggests, the lesions appear as small, pus-filled bumps. The pus, however, is not due to an infection. The lesions mainly appear on the hands and feet. In severe cases, the pustules may appear on most of the body surface needing medical attention.
• Nail psoriasis: It causes pitted, deformed, and easily breakable nails. In severe cases, the nails become crumbly and even separate from the nail bed.
• Erythrodermic psoriasis: It is a rare and serious condition that requires urgent medical attention. The skin on most of the body appears burnt, and the person appears fatigued and extremely sick. They may have severe itching, rapid pulse, chills, and fever. 
• Inverse psoriasis: It is also called flexural or intertriginous psoriasis. It typically affects the skin folds such as in the groin, buttocks, armpits, or under the breasts.