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MINDEF Healthy Lifestyle Website - Health Bulletin
Psoriasis
Psoriasis is a skin disorder than can occur at any age in both men and women. Most commonly, psoriasis first
appears as thick, flaky patches of skin on the elbows, knees, or other parts of the body. The patches may be
silver or red.
The skin flaking that occurs in psoriasis is known as scaling. At first, a few
small, flaky patches -- known as plaques-- may appear. Often, the plaques
gradually enlarge and increase in number. Less commonly, psoriasis may
erupt suddenly all over the body.
Psoriasis is a chronic disorder, which means it can last a long time and can
come back frequently. It is most common in people in their 20s, 30s, and 40s.
Psoriasis is rare under age 3. Most people who develop it do so before age 30.
In the United States, about two or three out of every 100 people have
psoriasis.
Psoriasis commonly occurs on pressure points such as the elbows, knees, and
knuckles, as well as on the scalp, the trunk, the arms and legs, the external
sex organs, and the fingernails and toenails.
The severity of psoriasis varies widely. The most common pattern is for the
disease to be limited to certain parts of the body but to recur (come back)
frequently. Once someone has had a flare-up of psoriasis, the chances are nine out of 10 that the disease will
recur. Psoriasis that begins earlier in life tends to be more severe and persistent.
Usually people with psoriasis are otherwise healthy and feel well. However, if psoriasis affects large areas of
the skin, it can seriously interfere with a person's ability to function normally. The thick, flaky patches of skin
are often disfiguring and can be itchy or painful. If the hands or feet are affected, a person may have difficulty
walking or holding a job. Caring for psoriasis is a daily, time-consuming process.
Psoriasis is an unpredictable condition that can sometimes flare up for no apparent reason. The course of the
disease can be different in every individual who has it. People with psoriasis commonly go through periods of
embarrassment, frustration, and depression about their condition. Because psoriasis affects exposed skin, it
is a highly visible disease.
Psoriasis is not an infection and it is not contagious - you cannot "catch" it from anyone.
How Severe Can Psoriasis Get?
Psoriasis is defined as mild, moderate, or severe, depending on how much of the skin is affected.
Mild psoriasis affects less than 2 percent of the skin.
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Moderate psoriasis affects 2 percent to 10 percent of the skin.
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Severe psoriasis affects more than 10 percent of the skin.
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As a general rule, the palm of one hand is roughly equal to one percent of the skin.
What Is Psoriatic Arthritis?
In about one out of every 10 people with psoriasis, the disease causes pain and swelling in the joints. This is
called psoriatic arthritis. This condition tends to wax and wane. It is less likely than other types of joint
disease, such as rheumatoid arthritis, to worsen over time and become disabling.
People with psoriasis may also have more common forms of arthritis. Rarely, people with psoriatic arthritis
may develop a disabling form of arthritis in which the joints become deformed.
Facts About Psoriasis
Psoriasis affects both men and women.
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The word psoriasis comes from a Greek word that means "to itch." However, psoriasis often
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does not itch. Psoriasis most commonly appears as thick, flaky patches of skin that may be silver
or red.
In psoriasis, skin cells reproduce many times faster than normal and live only three to four days.
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The dead cells build up on the skin, forming thick, flaky patches.
Psoriasis can occur at any age but is most common in people in their 20s, 30s, and 40s.
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In the United States, about two or three out of every 100 people have psoriasis.
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Psoriasis is not an infection and it is not contagious-you cannot "catch" it from anyone.
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In about one-third of cases, psoriasis is inherited. If both of a child's parents have psoriasis, the
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child's chances of getting the disease are about 50-50.
Presented by Health Education Section, Preventive Medicine Branch, HQ Medical Corps
MINDEF Healthy Lifestyle Website - Health Bulletin
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Skin injury, climate change, infection, drug reactions, and stress can all cause psoriasis to flare
up or worsen.
Strep throat can lead to a type of psoriasis called guttate psoriasis, which is most common in
children and young adults.
About one in 10 people with psoriasis will develop a type of arthritis called psoriatic arthritis.
There are several different types of psoriasis:
Plaque psoriasis
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Guttate psoriasis
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Psoriasis of special skin sites
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Other types of psoriasis
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Plaque Psoriasis
This is the most common type of psoriasis. It typically appears as thick, flaky
patches of skin on one or more parts of the body. Sometimes the patches of
affected skin are large, extending over much of the body. The patches,
known as plaques or lesions, can wax and wane but tend to be chronic.
Plaque psoriasis can occur anywhere on the body. Commonly affected sites
are the elbows, knees, knuckles, scalp, trunk, arms and legs, and external
sex organs. The plaques do not always itch, but when scratched they can
become inflamed. This is known as the Koebner phenomenon.
Guttate Psoriasis
This type of psoriasis most often affects children and young adults. It appears as small, red bumps-the size of
drops of water-on the skin. It usually appears suddenly, often several weeks after an infection such as strep
throat.
Antibiotics may be used to treat guttate psoriasis that is triggered by an infection. Guttate psoriasis usually
responds to treatment and may gradually go away on its own. Many people who have an episode of guttate
psoriasis may not have another one for many years.
In adults who have plaque psoriasis, the appearance of the small droplike bumps of guttate psoriasis can be a
sign that the disease is flaring up.
Psoriasis of Special Skin Sites
Psoriasis that affects the scalp is called seborrheic psoriasis. The scalp may be the first site to be
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affected by psoriasis. The condition may resemble severe dandruff. Patches of thick, flaky skin may
extend to the forehead below the hairline. Scales may build up in the outer ear. Other than the
forehead and the ears, the face is usually spared. However, some people may have patches of
inflamed skin that resemble seborrheic dermatitis, a type of dandruff eczema that affects the scalp
and face.
Psoriasis can affect the connective tissue that forms the nails. Pitting of the nails may be an early
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sign of nail psoriasis, although pitting can also occur in other diseases. Other signs of nail psoriasis
include the appearance of dark spots resembling oil droplets on the nails, the build-up of flaky skin
cells under the nails, and separation or loosening of the nails from their beds (onycholysis). One or
more nails may be affected.
Psoriasis that affects the palms of the hands and the soles of the feet is called palmoplantar
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psoriasis. It may appear as chronic flaky patches that crack and bleed. The nails may be affected as
well. In severe cases the condition can be disabling.
The palms and soles can also be affected by pustular psoriasis. In this condition small, deep, pusfilled blisters appear on the palms and soles. They may have a copper-coloured hue on a background
of red, flaky skin. This condition may also be called palmoplantar pustulosis or acropustulosis.
Other Types Of Psoriasis
Red, flaking, thickened skin that covers most of body is called erythroderma. When this happens in
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a person who has a history of plaque psoriasis, it is called erythrodermic psoriasis. Other causes of
erythroderma include widespread eczema (an inflammatory condition of the skin characterized by
redness, itching and oozing lesions), skin reactions to drugs, and a type of skin cancer called
cutaneous lymphoma. People with erythroderma may have fever and chills, and may need to be
treated in the hospital.
A rare and severe form of psoriasis in which small, pus-filled blisters appear on the skin is called
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pustular psoriasis. People with this condition may need to be treated in the hospital. They are
usually ill with fever and chills. They need special therapies because standard treatments for psoriasis
easily irritate their skin. Pustular psoriasis can be disabling when it affects the palms of the hands and
Presented by Health Education Section, Preventive Medicine Branch, HQ Medical Corps
MINDEF Healthy Lifestyle Website - Health Bulletin
soles of the feet.
Psoriasis that affects areas of the body where the skin folds, such as the armpits, groin, and webs of
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the toes, is called inverse psoriasis or flexural psoriasis. This type of psoriasis is often white in
colour, appears softened as if soaked by water, and may resemble a fungal infection.
Presented by Health Education Section, Preventive Medicine Branch, HQ Medical Corps