Almirall
Psoriasis

Psoriasis signs and symptoms

What are the symptoms of psoriasis?

psoriasis

Psoriasis symptoms can vary depending on the type and location. The most common type, plaque psoriasis, presents the following signs and symptoms:

  • Rounded red or oval spots lined with white or silver scales. Their size is variable, ranging from small patches to large plaques that can cover a large body surface.
  • Itching is one of the most frequent symptoms, and it may have a greater impact on quality of life.
  • Burning, pain, or bleeding. 

The most typical locations are the elbows, knees, scalp, and lower back area, but it can also appear anywhere on the skin. Lesions are often symmetrical, meaning they tend to show up on both sides of the body. Additionally, psoriasis can affect certain locations, called high-impact areas, that can have an increased negative impact on quality of life, regardless of the total area affected:

Scalp

About 80% of people with psoriasis will have scalp involvement at some point. It can also affect the hairline, the forehead, the back of the neck and the skin around the ears. 

Nails

About 50% of people with psoriasis have nail psoriasis. It normally affects several digits (fingers and toes) and is more common on the fingernails.

Skin folds

Inverse psoriasis can occur in skin folds such as the armpits and under the breasts. Certain factors, such as friction and sweating can make symptoms worse.

Genital psoriasis

About 33 to 63% of patients with psoriasis experience genital psoriasis. Genital psoriasis can affect the skin in the genital area, as well as the inner and upper thighs. 

Palms and soles of the feet

Psoriasis in these areas can have a very negative impact on quality of life. It is often accompanied by painful cracks and fissures that may bleed.

Face

Facial psoriasis is rare, but it is highly visible and has a significant psychological impact. It typically occurs on the eyebrows, the skin between the nose and upper lip, the upper forehead and the hairline.

The systemic inflammatory processes underlying psoriasis can manifest as or contribute to the development of other health conditions known as comorbidities. 

What is psoriatic arthritis?

Up to 30% of people with psoriasis develop psoriatic arthritis, typically with psoriasis developing before psoriatic arthritis. It can cause pain, swelling and stiffness, in joints including the hands, wrists, feet and spine. 

Other related health conditions

Psoriasis is associated with other health conditions, including:

 

Cardiovascular diseases

People with psoriasis, especially severe cases, have a higher risk of heart problems such as heart failure, stroke, and atherosclerosis.

Eye disease

Uveitis, which refers to inflammation in the eye, affects the middle layer of tissue in the eye wall (uvea) and is more common in patients with psoriasis. Symptoms include eye redness, pain, and blurred vision, and symptoms may come on suddenly and progress quickly.

Metabolic syndrome

This disorder is characterized by a cluster of conditions, including increased blood pressure, high blood sugar, excess body fat, and abnormal cholesterol levels, all of which significantly elevate the risk of heart disease, stroke, and type 2 diabetes. In individuals with psoriasis, manifestations of metabolic syndrome often include obesity, non-alcoholic fatty liver disease, hyperlipidemia, diabetes, and obstructive sleep apnea. These comorbidities further compound the risk of cardiovascular disease previously discussed, highlighting the systemic nature of psoriasis and its association with metabolic dysfunction.

Inflammatory bowel disease

Inflammatory bowel disease (IBD) Inflammatory bowel disease refers to conditions characterized by inflammation in the gastrointestinal tract. The two most common inflammatory bowel diseases are ulcerative colitis and Crohn’s disease. 

Kidney Disease

Severe psoriasis is associated with an increased risk of chronic kidney disease (CKD). some studies suggest that individiuals with severe psoriasis may be about twice as likely to develop CKD.

Cancer

People with psoriasis are at higher risk of certain cancers, especially lymphoma and non-melanoma skin cancers such as basal cell carcinoma and squamous cell carcinoma.

Mental health

Psoriasis can significantly impact psychological well-being, leading to depression, anxiety, and even suicidal thoughts, especially in severe cases. Stigma and social isolation worsen these issues. If you notice any symptoms such as persistent sadness, nervousness, or insomnia, seek medical advice. 

Ilse, living with Psoriasis

What to do if I observe any symptoms of psoriasis?

If you notice red patches, scaling, or joint pain, make an appointment with your doctor. Early diagnosis and treatment can help prevent complications and improve quality of life.

FAQs

References