What Does Psoriasis Look Like?

One might wonder, what does psoriasis look like? What are the signs and symptoms of psoriasis? In order to identify psoriasis, it is vital to look for characteristic skin changes which in many cases appear significantly at specific parts of body. It is common to see skin thickening, scaling and redness in psoriasis skin. Plus, these signs and symptoms of psoriasis do not affect only skin, but also nails, scalp and joints. Thus, to identify psoriasis signs and symptoms, we can split those based on features and locations.

What Does Psoriasis Look Like: Signs and Symptoms of Psoriasis Based on Features

1. Skin Plaques

Skin Plaques

Psoriasis vulgaris, or plaque-type psoriasis, is one of the most common types of psoriasis identified among patients. This type of psoriasis has three hallmarks; skin thickening, scaling and redness. The plaques vary from barely perceptible to several millimeters in terms of thickness. They appear in different colors from a faint pink to deep beefy red. However, the plaques are less redness but more darkened in patients with darker skin color. Apart from plaques, most patients may also develop scales which can range from almost invisible to thick adherent plates known as ostraceous scales which appear like oyster-shell.

2. Auspitz's Sign

Auspitz's Sign

Auspitz's sign is a pinpoint bleeding that may appear when adherent scales are scraped or picked off. This sign appears due to exposure of the tops of tiny blood capillaries which pass in a wavy pattern vertically throughout the thickened psoriasis skin.

3. Koebner Phenomenon

Koebnerization

When a fresh area of psoriasis grows in injured skin, an isomorphic response known as Koebner phenomenon or Koebnerization takes place. In other words, this phenomenon refers to the growth of psoriasis lesions at the site of injury. It can be induced due to non-traumatic skin injury such as sunburn, rubbing, bites and mechanical pressure. Duration of time between injury and lesion growth varies from a day to several weeks. Koebnerization can occur in a majority of psoriasis patients, but it is not a unique characteristic for psoriasis only.

4. Guttate, Pustular and Erythrodermic Psoriasis
These three types of psoriasis are the less common occur among patients, and they are significantly contrast from typical plaque-type psoriasis. Guttate-type psoriasis is characterized by presence of small, tiny, drop-like papules which are scattered throughout the skin. In contrast, pustular-type psoriasis is identified by appearance of pus-filled, yellowish, small blisters that can grow in smaller areas or involves most of the body. In the third type, erythrodermic psoriasis, the psoriasis lesions cause the entire body to appear bright red and scaly, and skin biopsy is needed to differentiate it from other skin diseases.

What Does Psoriasis Look Like: Signs and Symptoms of Psoriasis Based on Locations

1. Typical Locations

Typical Locations

Scalp, knees, elbow, genitals, belly button and buttocks area are typical locations where plaque-type psoriasis develops. In moist areas such as in the groin, under breasts or armpits, scales may appear wet and pasty. Besides, the lesions may grow into a damp, flat, red patches almost similar to yeast or fungal infections. On the scalp, one may see a severe form of dandruff-like flaking and scaling with red areas of skin.

2. Hand and Foot Lesions
It is either plaque-like lesions, as seen on other skin areas, or pustular-blisters filled with pus that are typically seen on the hands or feet of psoriasis patients. Even though the appearance of pustules is commonly associated with infections, but in psoriasis, they grow as a part of inflammatory reaction. On the palms or soles, presence of very thick and inflexible plaques can be identified. These plaques cause movement restriction and may crack when applied force. These can result in growth of fissures which can be painful and sometimes easily become infected. On foot, severe lesions can limit the ability of patients to walk, which then may end up in disability.

3. Finger and Toenails

Psoriasis of Finger

Psoriasis patients usually have thickened, lifted and pitted nails. As a unique feature of psoriasis, a large yellowish brown "oil spotting" may appear on nails. This is actually a darkened spot on almost transparent nail, resembling to the effect of a drop of oil on a piece of paper. Treatment for nail psoriasis can be difficult.

4. Joints (Psoriasis Arthritis)
When psoriasis affects joints, it is known as psoriasis arthritis. Psoriasis arthritis is an inflammatory, destructible form of arthritis and may appear in 10-30% of moderate to severe psoriasis patients. X-ray findings or blood tests are usually needed to differentiate the disease from other types of arthritis.

Different patients may have different signs and symptoms of psoriasis, based on the features and locations. Identifying psoriasis signs and symptoms can help in any further interventions to overcome the disease. For further understanding the disease, click here.

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