Psoriasis Symptoms

Skin concerns can often pop up with very little warning and even less explanation—and psoriasis is no exception. Psoriasis is an autoimmune condition that speeds up the growth of skin cells. 

Normally, the skin cell cycle is relatively long; it takes nearly one month for a skin cell to fully grow, move to the surface of the skin, and then fall off. In people with psoriasis, skin cells can grow within just three or four days. However, instead of shedding old skin, skin cells pile up and cause inflamed patches and scales on your body.   

Psoriasis mostly affects people between the ages of 15 and 35, however, people of any age can experience it. Researchers do not know the exact cause of the condition, however, they believe that a combination of genetics and immune system functioning may lead to the onset of symptoms. 

 There are five primary types of psoriasis:

• Plaque psoriasis
• Guttate psoriasis
• Inverse psoriasis
• Pustular psoriasis
• Erythrodermic psoriasis

Each type comes with its own set of symptoms. You can also have more than one type of psoriasis at the same time. Your treatment plan will vary depending on the type(s) of psoriasis you have and the symptoms you are experiencing.

Plaque Psoriasis Symptoms

Plaque psoriasis is the most common type of psoriasis and accounts for 80% to 90% of all cases. Symptoms of plaque psoriasis include:

• Inflamed patches (or, “plaques”) on the skin that appear pink or red on lighter skin tones and purple or brown on darker skin tones
• White, silver, or gray-colored scales 
• Dry or cracking skin 
• Itchiness 

Plaques can develop on any part of the body, but typically appear on the knees, elbows, scalp, and lower back. Plaques are often symmetrical, showing up in the same areas on the left and right sides of your body. The size of plaques may also vary between small and large.

People with plaque psoriasis may also be more likely to notice symptoms on their nails—a subtype of plaque psoriasis called nail psoriasis. In fact, nearly 50% of people with plaque psoriasis also have nail psoriasis. 

The most common symptoms of nail psoriasis include: 

• Deformities: Changes to the shape of the nails
• Pitting: Holes in the nails that can be shallow or deep
• Discoloration: A yellow, red, or brown hue in the nails
• Thickening: Nails may become chunky or dense 
• Onycholysis: A process that causes separation between your nail and your nail bed 

While nail psoriasis is more common in the fingernails, you may also notice symptoms in your toenails. Nail psoriasis symptoms can sometimes cause pain and make it difficult to complete hand-related tasks (e.g., picking up items or typing) or walk. 

Guttate Psoriasis Symptoms

This type of psoriasis generally affects up to 8% of people with psoriasis. People with guttate psoriasis may notice symptoms such as:

• Small and round lesions called papules
• Inflamed and raised skin
• Pink, red, or brown spots that appear on the arms, legs, torso, or back 

Guttate psoriasis symptoms can appear suddenly and most often affect children—though can develop at any age. In most cases, infections like chickenpox or strep throat can lead to the onset of guttate-type symptoms. 

Inverse Psoriasis Symptoms

Generally, 20% to 30% of people with psoriasis have the inverse type. Inverse psoriasis causes inflammation and patches in areas where your skin rubs against itself (also known as skin folds) such as the underarms, breasts, and groin. Skin folds tend to be more moist than other parts of your body. As a result, inverse psoriasis patches are not raised or scaly but are smooth. 

Patches may appear: 

• Dark red, purple, or brown on darker skin tones
• Pink or red on lighter skin tones
• Smooth or glistening 
• Raw or sore

Symptoms may worsen when you sweat, have deeper skin folds, or wear clothes that cause friction. 

Pustular Psoriasis Symptoms

This type of psoriasis is much more rare and affects only 3% of people with psoriasis. Symptoms of pustular psoriasis are:

• Pus-filled bumps called pustules 
• White or yellow-colored liquid or pus in the lesions
• Bumps that feel painful or hard 
• Pustules that are surrounded by inflamed and discolored skin patches 

In most cases, pustules appear on smaller parts of the body such as your fingers, palms of your hands, and toes. That said, pustules may disrupt activities that involve the hands and feet, such as walking, doing chores, or driving. 

Erythrodermic Psoriasis Symptoms

Only 2% of people with the condition have erythrodermic psoriasis, the rarest and most severe type. Erythrodermic psoriasis causes symptoms on the entire body and can be life-threatening. If you have this type of psoriasis, symptoms may include:

• Inflamed and scaly patches that cover the entire body
• Red or brown-colored rash 
• A large amount of skin peeling or shedding 
• Itching or burning sensation
• Fluctuating body temperature (e.g., feeling very hot then suddenly feeling very cold)
• Rapid heart rate
• Dehydration 

Keep in mind: this type of psoriasis does not develop on its own. Typically, people who have erythrodermic psoriasis start with a less severe form of psoriasis. You may be at a higher risk of progressing to a diagnosis of erythrodermic psoriasis if your body doesn’t respond to treatment, causing symptoms to worsen. 

If you begin to notice the symptoms of this type of psoriasis, seek medical care immediately. If left untreated, erythrodermic psoriasis can cause complications such as pneumonia or heart failure. 

When to See a Healthcare Provider

Psoriasis can sometimes mimic symptoms of other skin conditions like eczema or dermatitis. If you begin to experience changes to your skin or think you may be at risk for developing psoriasis symptoms, it is a good idea to reach out to your healthcare provider. If you notice skin patches, discoloration, or inflammation on your body, keep track of where you are experiencing symptoms and how long you have had them.

Your healthcare provider or dermatologist (a doctor who specializes in the skin) can complete a physical exam and order other tests to determine what is causing skin changes. 

A Quick Review

Psoriasis symptoms tend to vary based on the type of psoriasis you have: Plaque, guttate, inverse, pustular, or erythrodermic. Symptoms typically occur when your body speeds up the growth of new skin cells, causing them to pile up and develop patches, scales, or lesions. Generally, patches are also accompanied by inflammation and discoloration. 

Don’t wait too long to get tested. Keeping track of your symptoms and visiting a healthcare provider as soon as possible can help you get an early diagnosis and offer you treatment options that can help you manage your condition.