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Psoriasis is a common skin condition that causes skin redness and irritation. Most persons with psoriasis have thick, red skin with flaky, silver-white patches called scales.

See also: Guttate psoriasis

Plaque psoriasis

Psoriasis is a very common condition. The disorder may affect people of any age, but it most commonly begins between ages 15 and 35. It can appear suddenly or slowly. In many cases, psoriasis goes away and then flares up again repeatedly over time. The condition is not contagious.

Psoriasis seems to be an inherited disorder. That means it is passed down through families. Doctors think it probably occurs when the body's immune system mistakes healthy cells for dangerous substances. See: Inflammatory response

Skin cells grow deep in the skin and normally rise to the surface about once a month. In persons with psoriasis, this process is too fast and dead skin cells build up on the skin's surface.

Psoriasis may affect any or all parts of the skin. There are five main types of psoriasis.

• Erythrodermic -- The skin redness is very intense and covers a large area.
• Guttate -- Small, pink-red spots appear on the skin.
• Inverse -- Skin redness and irritation occurs in the armpits, groin, and in between overlapping skin.
• Plaque -- Thick, red patches of skin are covered by flaky, silver-white scales. This is the most common type of psoriasis.
• Pustular -- White blisters are surrounded by red, irritated skin.

The following may trigger an attack of psoriasis or make the condition more difficult to treat:

• Bacteria or viral infections, including strep throat and upper respiratory infections
• Dry air or dry skin
• Injury to the skin, including cuts, burns, and insect bites
• Some medicines, including anti-malaria drugs, beta-blockers, and lithium
• Stress
• Too little sunlight
• Too much sunlight (sunburn)
• Too much alcohol

In general, psoriasis may be severe in persons who have a weakened immune system. This may include persons who have:

• AIDS
• Autoimmune disorders (such as rheumatoid arthritis)
• Cancer chemotherapy

Up to 30% of people with psoriasis may also have arthritis, a condition known as psoriatic arthritis. Psoriasis may also affect the nails. About 10% of people with psoriasis have visible changes only in the nails.

Persons with psoriasis have irritated patches of skin. The redness is most often seen on the elbows, knees, and trunk, but can appear anywhere on the body. For example, there may be flaky patches on the scalp.

The skin patches or dots may be:

• Pink-red in color (like the color of salmon)
• Dry and covered with silver, flaky skin (scales)
• Raised and thick

Additional symptoms may include:

• Genital lesions in males
• Joint pain or aching (psoriatic arthritis)
• Nail changes, including nail thickening, yellow-brown spots, dents (pits) on the nail surface, and separation of the nail from the base

Your doctor will look at your skin. Diagnosis is usually based on what the skin looks like.

Sometimes, a skin biopsy is done to rule out other possible conditions. If you have joint pain, your doctor may order x-rays.

See: Psoriasis support group

Psoriasis is a life-long condition that can be controlled with treatment. It may go away for a long time and then return. With appropriate treatment, it usually does not affect your general physical health.

• Pain
• Severe itching
• Secondary skin infections
• Side effects from medicines used to treat psoriasis

Call your health care provider if you have symptoms of psoriasis or if the skin irritation continues despite treatment.

Make sure you tell your doctor if you have joint pain or fever with your psoriasis attacks.

Go to the emergency room or call the local emergency number (such as 911) if you have a severe outbreak that covers all or most of the body.

There is no known prevention. Keeping skin clean and moist and avoiding your specific psoriasis triggers may help reduce the number of flare-ups.

Doctors recommend daily baths or showers for persons with psoriasis. Avoid scrubbing too hard, because this can irritate the skin and trigger an attack.

Habif TP. Clinical Dermatology. 4th ed. St. Louis, Mo: Mosby; 2004.

Luba KM. Chronic plaque psoriasis. Am Fam Physician. Feb 2006; 73(4): 636-44.

Stern RS. Psoralen and ultraviolet a light therapy for psoriasis. N Engl J Med. 2007 Aug 16;357(7):682-90. Review.

Menter A, Griffiths CE. Current and future management of psoriasis. Lancet. 2007 Jul 21;370(9583):272-84.