[Medical Q&A] What are the common types of psoriasis?

Planner: Chinese Medical Association

Reviewer: Zhang Guoqiang, Chief Physician, First Hospital of Hebei Medical University

Common types of psoriasis include vulgaris, arthritis, pustular, and erythrodermic.

(1) Psoriasis vulgaris: includes plaque psoriasis and guttate psoriasis. Plaque psoriasis accounts for the vast majority (about 90%), and clinical manifestations are plaques of varying sizes, mostly appearing on the scalp, trunk, face, and extensor surfaces of the limbs. There may also be symptoms where small plaques merge into large plaques covering the entire body.

(2) Arthritis-type psoriasis: Also known as psoriatic arthritis. Four out of every ten psoriasis patients will develop joint lesions. Clinical manifestations include pain, redness, swelling, morning stiffness, and even disability in the joints.

(3) Pustular psoriasis: includes generalized pustular psoriasis and localized pustular psoriasis. The clinical manifestations are pinpoint to millet-sized pustules on the basis of erythema, mostly appearing on the nails, palms, and soles. Pustules fuse to form large areas of pus, accompanied by fever, myalgia, geographic tongue, grooved tongue, and wrinkled tongue.

(4) Erythrodermic psoriasis: This is a rare severe form of psoriasis, with clinical manifestations of diffuse flushing (greater than 90% of the body surface area), swelling and a large amount of scaling. The erythema almost covers the entire body, and is often accompanied by fever, chills, and superficial lymphadenopathy.

(5) Other rare types

1) Inverse psoriasis: In contrast to plaque psoriasis, the rash of inverse psoriasis usually grows on the flexural parts of the body that are prone to sweating, such as the elbows, knees, and armpits. The rash is usually an infiltrative erythema with fewer scales on the surface.

2) Palmoplantar pustulosis: It often occurs on the palms and soles of the feet. The rash may be accompanied by pustules and nail lesions, and may even cause nail pain and cracking.

3) Nail psoriasis: It is psoriasis that grows on the nails and may cause lesions in the nail matrix, nail bed, hypoungual cuticle, and proximal nail fold.