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.
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.
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.
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.
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.
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.