The popular English phrase, ‘The Seven Year Itch’ has humorous and
sarcastic connotations to it. However, consider living with a literal
itch for seven years or more and it’s not that funny anymore. Psoriasis
is an ailment of the skin which results in dry itchy rashes that come
and go throughout a person’s lifetime. Neither life threatening nor
contagious yet equally traumatizing as most chronic diseases, psoriasis
has medical researchers and doctors all over the world, perplexed and
worried.
Little is known for sure about this disease of the skin and with
little concrete knowledge to work with researchers have a long way to go
before a permanent cure is discovered. Thankfully with the advance of
modern medicine, psoriasis can be accurately diagnosed and classified
into its many subtypes and with this knowledge has come the ability to
relieve the uncomfortable and traumatizing symptoms of psoriasis. Let’s
take a detailed look at the different types of psoriasis and its
treatments.
Psoriasis types and their treatments
1. Plaque Psoriasis:
The most common type of psoriasis, plaque psoriasis manifests itself
as raised, red patches covered with a whitish buildup of dead skin cells
with an almost scaly appearance. These patches usually appear on the
knees, elbows, the scalp, lower back, palms and the soles of the feet.
When biopsied, plaque psoriasis skin is thicker and more inflamed in
comparison to eczema.
Treatment
Though no single psoriasis treatment works for everyone, a
combination of topical medications, drugs and even phototherapy which is
the process of exposing the affected skin to ultra violet light often
helps to bring psoriasis into remission.
2. Guttate Psoriasis:
This type of psoriasis is the second most common psoriasis that often
starts early on during childhood or early adulthood. Characterized by
multiple red spots all over the body, commonly on the trunk and limbs,
guttate psoriasis affected skin is not as thick as that of plaque
psoriasis and can also co-exist with other forms of psoriasis. Guttate
psoriasis is often triggered by respiratory infections, tonsillitis,
streptococcal infections, stress and injury to the skin.
Treatment
As with plaque psoriasis, guttate psoriasis is treated by a
combination of topical medications, oral medications and phototherapy.
3. Inverse Psoriasis:
Intertriginous psoriasis, commonly known as inverse psoriasis appears
as lesions under the folds of the skin. Commonly found in the groins,
armpits, under the breasts and in other skin folds, inverse psoriasis
appears as red and often smooth and shiny lesions. Common to unexposed
areas vulnerable to sweat and humidity, it is often very itchy and
bothersome. It is more common in overweight people with deep skin folds
and is also found in a combination with other types of psoriasis.
Treatment
Most commonly treated with topical medications and oral drugs.
Phototherapy is only used in extreme cases. Common topical medications
for inverse psoriasis are Tacrolimus and Pimecrolimus.
4. Pustular Psoriasis:
Characterized by pustules or blisters of non-infectious pus, pustular
psoriasis though not so common, is perhaps the most traumatizing of all
forms of psoriasis. The pus in the blisters consists of white blood
cells that aren’t infectious or contagious. Pustular psoriasis is
generally found in adults and may be predominant in certain areas of the
body such as the hands and feet. The common triggers for pustular
psoriasis are pregnancy, emotional stress, certain medications,
overexposure to UV light and other factors.
Treatment
Acitretin, cyclosporine, methotrexate, oral PUVA (the
light-sensitizing drug psoralen plus ultraviolet light A) and TNF-alpha
blockers, such as infliximab are the common means of treating pustular
psoriasis.
5. Erythrodermic Psoriasis:
The rarest psoriasis type, Erythrodermic psoriasis manifests itself
as red and itchy skin over a large area. Unlike other forms of
psoriasis, the skin sheds in sheets instead of flakes and fluid loss can
be almost fatal. Internal symptoms of this form of psoriasis could be
unstable body temperatures and a higher heart rate.
Treatment
Particularly difficult to treat, erythrodermic psoriasis is often
initially treated with topical steroids and moisturizers. However,
treatment gets more complicated with time and often a combination of
treatment including oral drugs and topical medications, UV exposure and
oral PUVA is needed.
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