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Can You Have More Than One Type Of Psoriasis

What Is Cdc Doing About Psoriasis

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In 2010, CDC worked with experts in psoriasis, psoriatic arthritis, and public health to develop a public health perspective that considers how these conditions affect the entire population. The resulting report is Developing and Addressing the Public Health Agenda for Psoriasis and Psoriatic Arthritis pdf icon. You can read a short article about the agendaexternal icon in The American Journal of Preventive Medicine.

CDCs National Health and Nutrition Examination Survey , an intermittent source of national psoriasis data, has included questions about psoriasis as late as the 2013-2014 cycle. A recent analysis of NHANES data estimates that 7.4 million adults had psoriasis in 2013external icon.

  • Psoriasis causes patches of thick red skin and silvery scales. Patches are typically found on the elbows, knees, scalp, lower back, face, palms, and soles of feet, but can affect other places . The most common type of psoriasis is called plaque psoriasis.
  • Psoriatic arthritis is an inflammatory type of arthritis that eventually occurs in 10% to 20% of people with psoriasis. It is different from more common types of arthritis and is thought to be related to the underlying problem of psoriasis.
  • Psoriasis and psoriatic arthritis are sometimes considered together as psoriatic disease.

Who is at risk for psoriasis?

Anyone can get psoriasis. It occurs mostly in adults, but children can also get it. Men and women seem to have equal risk.

Can I get psoriasis from someone who has it?

What Is Metabolic Syndrome

Metabolic syndrome describes a group of risk factors that increase the risk for type 2 diabetes and heart disease. Just as people with psoriasis are at increased risk for diabetes, metabolic syndrome is more common in people with psoriasis. One study showed a strong link between the two. This means that people with psoriasis tend to be more likely to develop metabolic syndrome. This connection is likely even stronger in people with more severe psoriasis. The risk factors that make up metabolic syndrome include:

  • Increased waist size

  • High blood pressure

What Procedures And Tests Diagnose Guttate Psoriasis

Guttate psoriasis is a medical condition that is typically diagnosed after a doctor or health care professional performs a physical exam of the skin. The dermatologist generally can tell if it is psoriasis just by clinical judgment based on the appearance of the skin lesions.

Skin biopsies are occasionally necessary to confirm diagnosis of psoriatic lesions.

Blood tests to rule out other treatable diseases may be necessary. In young children, certain drug eruptions and occasionally viral rashes can be confused with guttate psoriasis.

Findings from blood tests may confirm that the patient had a streptococcal infection recently. Increased levels of antibodies to the streptolysin-O are present in more than one-half of patients.

    This type of psoriasis may be treated at home in most mild to moderate cases. Keeping the skin moist will prevent extra irritation. Thick moisturizers applied after a bath to keep in moisture and soften the skin are helpful.

    If it is summertime or the patient is in a part of the country where there is plenty of sunlight, careful graded increases in sun exposure may be quite helpful in diminishing the eruption. One must take special care to avoid a sunburn because this can occasionally result in an exacerbation of the eruption.

    Over-the-counter topical steroids like 1% hydrocortisone cream may help to reduce inflammation and itching.

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    Enhancing Healthcare Team Outcomes

    Plaque psoriasis is a complex life long disorder with enormous morbidity. Thus, it is best managed by an interprofessional team.

    Insulin resistance and cardiovascular diseases are more common in psoriatic patients as are metabolic comorbidities. Obesity is the most common comorbidity observed in children with psoriasis. Many patients present with reduced quality of life and psychological manifestations and need special attention and counseling. Thus, primary care clinicians should advocate lifestyle modification such as reducing weight, reducing alcohol intake and smoking cessation may help control psoriasis, improve the results of treatment and prevent future complications.

    Sudden onset, palmoplantar keratoderma, severe nail dystrophy, the involvement of skin folds should arouse suspicion of associated HIV infection in whom pustular forms are also more common with a higher frequency of arthritis.

    Teaching Points

    Outcomes

    What Is Erythrodermic Psoriasis

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    This is an uncommon but very serious form of psoriasis. Only 3 percent of people with psoriasis will develop erythrodermic psoriasis in their lifetime, according to the NPF.

    This type usually occurs in people who have uncontrolled plaque psoriasis.

    Erythrodermic psoriasis causes extremely red or otherwise discolored skin that affects most of the body.

    Symptoms include:

    • Pitting on nails
    • Ridges or grooves in your nails
    • Lifting of the nail away from the skin
    • Crumbling of nails

    Many people with plaque psoriasis also have nail psoriasis. For some, however, a single nail involvement may be the only form of psoriasis they develop.

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    What Causes Psoriasis Outbreaks

    Psoriasis outbreaks differ from person to person. No one knows exactly what causes flare-ups. Common psoriasis triggers may include:

    • Skin injury .
    • Streptococcal or other infection that affects the immune system.
    • Certain prescription medications .
    • Cold weather, when people have less exposure to sunlight and humidity and more to hot, dry indoor air.

    How Does A Dermatologist Diagnose Psoriasis

    To diagnose psoriasis, a dermatologist:

    • Examines a patients skin, nails, and scalp for signs of psoriasis.
    • Asks whether family members have psoriasis.
    • Learns about what has been happening in the patients life. A dermatologist may want to know whether a patient has been under a lot of stress, had a recent illness, or just started taking a medicine.

    Sometimes a dermatologist also removes a bit of skin. A dermatologist may call this confirming the diagnosis. By looking at the removed skin under a microscope, one can confirm whether a person has psoriasis.

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    How Common Is It To Have More Than One Type

    Plaque psoriasis is usually the first type to develop in people who have more than one type of psoriasis. As many as 30 percent of those with plaque psoriasis may develop psoriatic arthritis. About 50 percent of people with plaque psoriasis will also havepsoriasis of the nails, although its also possible for nail psoriasis to develop before skin psoriasis. Nearly 80 percent of people with psoriatic arthritis will develop nail psoriasis, as well. In people with pustular psoriasis, up to 40 percent may develop psoriatic arthritis.

    Rates for other types of psoriasis are less defined. Its possible to develop the risk factors for a second type of psoriasis such as weight gain, strep throat infection, suddenly stopping psoriasis medication, or poor control of existing psoriasis and consequently begin to show symptoms of the new type, as well.

    What Can Prevent Someone From Getting A Second Type Of Psoriasis

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    Most types of psoriasis cannot be prevented.

    That said, if you already have plaque psoriasis, it may be possible to reduce your risk of developing another type of psoriasis on your skin. Dermatologists recommend taking the following precautions:

    • Protect your skin to prevent sunburn

    • Take medication as directed and speak with your dermatologist before stopping a medication

    • Treat your psoriasis so that its well-controlled

    • Watch your weight so that you stay at a weight thats recommended for your age and height

    Watching your weight may help prevent inverse psoriasis. This type of psoriasis is more common in people who are 20 or more pounds overweight.

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    Main Symptoms Of Psoriasis

    Psoriasis typically causes patches of skin that are dry, red and covered in silver scales. Some people find their psoriasis causes itching or soreness.

    There are several different types of psoriasis. Many people have only 1 form at a time, although 2 different types can occur together. One form may change into another or become more severe.

    Most cases of psoriasis go through cycles, causing problems for a few weeks or months before easing or stopping.

    You should see a GP if you think you may have psoriasis.

    What Is Guttate Psoriasis

    Guttate psoriasis is the second most common psoriasis type.

    It affects about 10 percent of people with psoriasis, according to the National Psoriasis Foundation .

    Guttate psoriasis, from the Latin for raindrop shaped, causes small, dot-like spots on the body. These lesions frequently appear on the upper arms, trunk, thighs, or scalp.

    Often, this form of psoriasis starts in childhood or young adulthood.

    Guttate psoriasis can be triggered by a strep infection, tonsillitis, stress, a skin injury, or certain medication . Sometimes genetic factors are to blame.

    Guttate psoriasis may clear up on its own, but certain cases require treatment. Some patients may experience guttate psoriasis just once, while others may find it leads to plaque psoriasis.

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    How Long Does Guttate Psoriasis Last

    • Although guttate psoriasis usually clears up within a few weeks, it may also be the first step to chronic plaque psoriasis, especially if it lasts for longer than a year.
    • The acute guttate form progresses into the chronic plaque form in an estimated 33% of people.
    • In another study of 15 patients, the likelihood of an individual developing chronic psoriasis within 10 years of a single episode of acute guttate psoriasis was suggested to be about one in three. Although further studies with larger numbers of patients are needed to determine the risk more accurately.
  • Like other forms of psoriasis, guttate psoriasis has the tendency to improve during the summer and worsen during the winter. Once the outbreak clears, many patients with acute guttate psoriasis usually have limited or no evidence of psoriasis for prolonged periods.
  • Is There A Link Between Psoriasis And Type 1 Diabetes

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    Type 1 diabetes is an autoimmune disease where the pancreas cant make any insulin. For this reason, people with type 1 diabetes must take insulin to control their blood sugars. Experts do think there is a connection between type 1 diabetes and psoriasis. The main link is that they are both autoimmune diseases that cause inflammation in the body. Experts think the cause of this inflammation is similar in both diseases.

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    What Causes Guttate Psoriasis

    An outbreak of guttate psoriasis is thought to be triggered by a previous streptococcal infection or some other type of infection. The precise mechanism whereby streptococcal infections induce psoriasis awaits more research.

    Since psoriasis may be inherited, those with a family history of psoriasis have an increased chance of developing the guttate form of the disease. Some people carry genes that make them more likely to develop psoriasis. The precise manner in which these genes interact with molecules produced by streptococcal bacteria or other microorganisms resulting in guttate psoriasis is currently not fully understood.

    Lets Get The Basics On The Seven Different Types Of Eczema

    Atopic dermatitis is the most common type of eczema, affecting more than 9.6 million children and 16.5 million adults in the United States. For complex reasons that researchers are still studying, the immune system becomes overactive, triggering inflammation that damages the skin barrier, leaving it dry and prone to itching, rashes and infection. AD is usually treated with moisturizing lotions, topic corticosteroids, non-steroidal topicals and biologics. Lifestyle changes to lower stress and ensure regular sleep and healthy dietary habits can also help.How to know if you have it: AD can appear anywhere on the body and at any time of life, but it often appears in childhood and tends to be chronic. It can be hereditary and it is more likely to happen to people who have asthma, hay fever and/or food allergy.

    Contact dermatitisoccurs when your skin becomes irritated or inflamed in response to physical contact with an allergen unlike atopic dermatitis, contact dermatitis does not run in families and isnt associated with other allergic conditions such as asthma or allergic rhinitis. Standard treatments include topical steroids, as well as patch testing to determine the source of the allergen.How to know if you have it: Contact dermatitis can appear out of the blue and typically disappears when the allergen or irritant is removed. It usually occurs in the spot where your body comes into contact with the allergen or irritant.

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    Are There Any Universal Triggers To All The Different Types Of Eczema

    According to Dr. Lio, soaps and detergents can trigger almost anyone to flare up in the right context. I would also argue that stress is a fairly universal trigger, he added. Allergens are much more nuanced and individualized. Environmental stressors like heat and cold are fairly common, but not universal.

    How Is Psoriasis Diagnosed And Treated

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    Psoriasis often has a typical appearance that a primary care doctor can recognize, but it can be confused with other skin diseases , so a dermatologist is often the best doctor to diagnose it. The treatment of psoriasis usually depends on how much skin is affected, how bad the disease is , or the location . Treatments range from creams and ointments applied to the affected areas to ultraviolet light therapy to drugs . Many people who have psoriasis also have serious health conditions such as diabetes, heart disease, and depression. Some people with psoriasis also have an inflammatory condition which affects their joints, called psoriatic arthritis.

    Psoriatic arthritis has many of the same symptoms as other types of arthritis, so a rheumatologist is often the best doctor to diagnose it. The treatment of psoriatic arthritis usually involves the use of drugs .

    Psoriatic disease may be treated with drugs or a combination of drugs and creams or ointments.

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    Who Gets Psoriasis That Affect The Joints

    Years after developing psoriasis on their skin, some people get a type of arthritis called psoriatic arthritis, which affects the joints. Its also possible to develop psoriatic arthritis before getting psoriasis on your skin.

    Its not possible to predict who will get psoriatic arthritis. For this reason, its important for people who have psoriasis to pay attention to their joints.

    Without treatment, psoriatic arthritis can worsen and damage joints. This damage is irreversible and can cause a lifelong disability. Treatment can prevent psoriatic arthritis from worsening.

    Early warning signs of psoriatic arthritis include:

    • A swollen and tender joint, especially within a finger or toe

    • Heel pain

    • Swelling on the back of your leg, just above your heel

    • Stiffness in the morning that fades during the day

    Generalised Pustular Psoriasis Or Von Zumbusch Psoriasis

    This causes pustules that develop very quickly on a wide area of skin. The pus consists of white blood cells and is not a sign of infection.

    The pustules may reappear every few days or weeks in cycles. During the start of these cycles, von Zumbusch psoriasis can cause fever, chills, weight loss and fatigue.

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    How Do People Get A Second Type Of Psoriasis On Their Skin

    While theres no way to predict who will develop a second type of psoriasis, some people may be more susceptible. For example, having severe psoriasis that isnt well controlled, stopping a strong medication too quickly, or getting strep throat may increase your risk.

    The following explains how people who have plaque psoriasis, the most common type of psoriasis, can develop a second type of psoriasis on their skin.

    Youll also find out how plaque psoriasis can turn into a different type of psoriasis.

    Inverse psoriasis: Many people gain a lot of weight after getting plaque psoriasis. Researchers arent sure why this happens, but they have discovered that extra pounds can increase your risk of developing inverse psoriasis.

    Inverse psoriasis only forms in areas where skin touches skin, such as the armpits, groin, or underneath the breasts. It causes smooth, bright-red patches of raw-feeling skin.

    Guttate psoriasis: Some people with plaque psoriasis have developed guttate psoriasis after getting an infection, such as strep throat. Guttate psoriasis causes spots on the skin that are small, pink to salmon-colored, and scaly. These spots are often widespread, appearing on the torso, legs, and arms.

    Erythrodermic psoriasis: Some people who have severe plaque psoriasis see their plaque psoriasis turn into erythrodermic psoriasis. This can happen when:

    Different ways that psoriasis can affect the nails

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    Okay.Right.And do you sort of know these different stages of your skin how it goes up and down and?Psoriasis subtype: scalp psoriasissymptoms body Tar-based shampoosspecial steroid ointmentsAnd did it help with what the dermatology department suggested of combing through your hair, did that help at all?Psoriasis subtype: nail psoriasisPsoriasis subtype: genital psoriasis

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    What Else Should I Ask My Healthcare Provider

    If you have psoriasis, ask your healthcare provider:

    • How can I prevent outbreaks and control symptoms?
    • What medication will work best for me?
    • What else should I do to improve symptoms?
    • What are my options if creams dont work?
    • Will psoriasis ever go away?

    A note from Cleveland Clinic

    Psoriasis, an itchy skin condition, can come and go throughout your life. Its related to an overactive immune response and is not contagious. If you have skin changes that arent going away, talk to your healthcare provider. There is no cure for psoriasis, but psoriasis treatments can improve symptoms. Your provider may prescribe a special cream or moisturizer or medications. Other therapies are available if creams or medicines dont work. Maintaining your overall health will also help improve symptoms.

    Last reviewed by a Cleveland Clinic medical professional on 10/17/2020.

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