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What Are the Types of Psoriasis?

Psoriasis, an autoimmune skin condition, causes the skin to appear red, thick, scaly, and flaky. There are five types of psoriasis, which include plaque psoriasis, inverse psoriasis, guttate psoriasis, pustular psoriasis, and erythrodermic psoriasis.
Psoriasis, an autoimmune skin condition, causes the skin to appear red, thick, scaly, and flaky. There are five types of psoriasis, which include plaque psoriasis, inverse psoriasis, guttate psoriasis, pustular psoriasis, and erythrodermic psoriasis.

Psoriasis is a chronic autoimmune skin condition that can cause skin to be red, thick, scaly, and flaky.

There are five main types of psoriasis: 

  • Plaque Psoriasis
    • The most common type of psoriasis, affecting up to 80% of patients 
    • Characterized by raised, inflamed, and scaly patches of skin that may also be itchy and painful (plaques) that can occur anywhere on the body 
    • Skin may be red with silvery white scales or may appear purple-ish, depending on a person’s skin type 
    • Plaques most often appear on the scalp, knees, elbows, and in or around the belly button and lower back, but can develop on any area of the body
  • Inverse Psoriasis
    • Affects 25% of people who have psoriasis
    • Characterized by inflamed deep-red skin that is smooth and not scaly
    • Develops in skin folds in the body such as the armpits, under breasts, the genital area, and buttocks 
    • Can cause severe itching and pain and that may be worsened by sweat and rubbing the affected areas
  • Guttate Psoriasis
    • Affects about 8% of psoriasis patients 
    • Characterized by small, round, red spots caused by inflammation
    • Frequently develops on the arms, legs and torso but can affect any part of the body
  • Pustular Psoriasis
    • Affects about 3% of people with psoriasis
    • Characterized by white, pus-filled, painful bumps (pustules) that may be surrounded by inflamed or reddened skin
    • May develop only on certain areas of the body, such as the hands and feet as in palmoplantar psoriasis, or it may affect most of the body
  • Erythrodermic Psoriasis
    • Rare, affects about 2% of people who have psoriasis 
    • Often affects almost the entire body and can be life-threatening
    • Characterized by intense redness and shedding of skin layers in large sheets
    • Other symptoms include: 
      • Severe itching and pain
      • Changes in heart rate and temperature
      • Dehydration
      • Nail changes

What Is the Treatment for Psoriasis?

There is no cure for psoriasis, but treatments can relieve the symptoms. Treatment for psoriasis includes: 

  • Topical treatments, such as creams and ointments
    • Over-the-counter (OTC) topical treatments
      • Salicylic Acid
      • Coal Tar
      • Moisturizers
        • Fragrance-free
        • Apply after showering and hand washing
        • Use moisturizing soaps
        • Shower in lukewarm water and limit showers to 10 minutes or less
      • Bath solutions such as oil, oatmeal, Epsom salts or Dead Sea salts
      • Scale lifters (keratolytics) usually contain an active ingredient of salicylic acid, lactic acid, urea, or phenol 
      • Coverings (occlusion) applied over topical treatments such as plastic wrap, cellophane, waterproof dressing, cotton socks or a nylon suit
      • Anti-itch treatments such as calamine, hydrocortisone, camphor, diphenhydramine hydrochloride (HCl), benzocaine, and menthol (may increase irritation and dryness)
      • Aloe vera, jojoba, zinc pyrithione, capsaicin and others may also help moisturize, soothe, remove scale, or relieve itching 
      • Castederm for inverse psoriasis to help dry moist plaques in the folds of the body
    • Prescription topical treatments
      • Steroids
      • Anthralin
      • Calcipotriene (Dovonex) 
      • Calcipotriene and betamethasone (Taclonex)
      • Tazarotene (Tazorec)
      • Calcitriol (Vectical)
  • Phototherapy (light therapy)
    • Psoralen + UVA (PUVA) 
    • Ultraviolet light B (UVB): broad band and narrow band
  • Systemic treatments
    • Biologics and biosimilars
      • Tumor necrosis factor-alpha (TNF-alpha) inhibitors such as certolizumab pegol (Cimzia), etanercept (Enbrel), adalimumab (Humira), infliximab (Remicade), golimumab (Simponi and Simponi Aria)
      • Interleukin 12 and 23 (IL-12, IL-23) inhibitors such as ustekinumab (Stelara)
      • Interleukin 17 (IL-17) inhibitors such as secukinumab (Cosentyx), brodalumab (Siliq), and ixekizumab (Taltz)
      • Interleukin 23 (IL-23) inhibitors such as tildrakizumab-asmn (Ilumya), risankizumab-rzaa (Skyrizi), and Tremfya (guselkumab)
      • T-cell inhibitors such as Orencia (abatacept)
      • Biosimilars to adalimumab (Humira): adalimumab-atto (Amjevita), adalimumab-afzb (Abrilada), adalimumab-adbm (Cyltezo), adalimumab-bwwd (Hadlima), adalimumab-fkjp (Hulio), and adalimumab-adaz (Hyrimoz) 
      • Biosimilars to infliximab (Remicade): infliximab-axxq (Avsola), infliximab-dyyb (Inflectra), infliximab-qbtx (Ixifi), and infliximab-abda (Renflexis) 
      • Biosimilars to etanercept (Enbrel): etanercept-szzs (Erelzi) and etanercept-ykro (Eticovo) 
    • Disease-modifying antirheumatic drugs (DMARDs) including tofacitinib (Xeljanz and Xeljanz XR)
    • Traditional oral systemics
      • Acitretin (Soriatane)
      • Cyclosporine
      • Methotrexate
      • Off-label systemics, including hydroxyurea (Hydrea), isotretinoin, mycophenolate mofetil, sulfasalazine, and 6-Thioguanine 
    • Nonsteroidal anti-inflammatory drugs (NSAIDs), including aspirin and ibuprofen (Advil, Motrin)

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References
https://www.uptodate.com/contents/psoriasis-the-basics?search=psoriasis&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1

https://www.psoriasis.org/