Flexural Or Inverse Psoriasis
Flexural or inverse psoriasis often appears in skinfolds, such as under the breasts or in the armpits or groin area. This type of psoriasis is red and often shiny and smooth.
The sweat and moisture from skinfolds keeps this form of psoriasis from shedding skin scales. Sometimes its misdiagnosed as a fungal or bacterial infection. The skin-on-skin contact can make inverse psoriasis very uncomfortable.
Most people with inverse psoriasis also have a different form of psoriasis in other places on the body.
Are There Complications Of Psoriasis
In some people, psoriasis causes more than itchiness and red skin. It can lead to swollen joints and arthritis. If you have psoriasis, you may be at higher risk of:
- Use medicated shampoo for scales on your scalp.
Other steps you should take to stay as healthy as possible:
- Talk to your healthcare provider about lowering your risk for related conditions, such as heart disease, depression and diabetes.
- Lower your stress with meditation, exercise or seeing a mental health professional.
Rash On Elbows And Knees Only
Psoriasis causes Itchy, red patches covered with silvery-white flaky skin. Common sites are the elbows and knees.
Discoid eczema is an allergy-related chronic skin condition. Discoid eczema is marked by itching, inflammation, redness, and scaling of coin-shaped patches on the skin. Discoid eczema is an uncommon type of eczema, a form of dermatitis.
Discoid eczema is also called nummular dermatitis and gravitational discoid eczema.
Discoid eczema causes rashes on the elbows and knees only and rarely do these rashes move to other areas of the body.
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What If Those Psoriasis Treatments Dont Work
If psoriasis doesnt improve, your healthcare provider may recommend these treatments:
- Light therapy: UV light at specific wavelengths can decrease skin inflammation and help slow skin cell production.
- PUVA: This treatment combines a medication called psoralen with exposure to a special form of UV light.
- Methotrexate: Providers sometimes recommend this medication for severe cases. It may cause liver disease. If you take it, your provider will monitor you with blood tests. You may need periodic liver biopsies to check your liver health.
- Retinoids: These vitamin A-related drugs can cause side effects, including birth defects.
- Cyclosporine: This medicine can help severe psoriasis. But it may cause high blood pressure and kidney damage.
- Immune therapies: Newer immune therapy medications work by blocking the bodys immune system so it cant jumpstart an autoimmune disease such as psoriasis.
What Kind Of Doctor Treats Psoriasis
There are several types of doctors who may treat psoriasis. Dermatologists specialize in the diagnosis and treatment of skin disorders, including psoriasis. Rheumatologists specialize in the treatment of joint disorders, including psoriatic arthritis. Family physicians, internal medicine physicians, rheumatologists, dermatologists, and other medical doctors may all be involved in the care and treatment of patients with psoriasis.
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Rash On Elbows Does Not Itch
Psoriasis is a chronic skin condition thought to be caused by an immune system dysfunction. If you have psoriasis, your immune system sends signals to your skin that speed up the production of skin cells.
There are five types of psoriasis , none of which is contagious. Each type causes a different skin rash and appears on different areas of the body.
Its estimated that about 7.5 million Americans live with psoriasis. The condition does respond to treatment, but it may never go away completely and tends to come back. But because psoriasis can look like other skin conditions that cause itchy, scaly rashes with inflammation but these rashes dont itch it is often confused with those disorders.
Skin Dryness And Scaling
Up to 90 percent of patients with hypothyroidism experience skin dryness and scaling, according to the medical textbook Werner & Ingbars The Thyroid.
When examined under the microscope, the skin of patients with hypothyroidism exhibits thinning and increased keratin, a protein found in the uppermost layer of the skin and in the hair and nails. The increased keratin and impaired shedding of old cells gives the skin a scaly appearance.
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What Are The Treatment Options
Though the underlying causes are different, treatment is generally similar, Dr. Fernandez says. You should see a dermatologist for any rash that doesnt go away with over-the-counter medicine, he says.
- Topical cortisone, especially if you have a mild case.
- Immunosuppressive drugs for more moderate to severe cases.
- or ultraviolet light treatment for severe cases.
Also, eczema can prompt a secondary infection so your doctor may use topical and systemic antibiotics to remove bacteria and calm the inflammation.
Articles On Types Of Psoriasis
Knowing which kind of psoriasis you have helps you and your doctor make a treatment plan. Most people have only one type at a time. Sometimes, after your symptoms go away, a new form of psoriasis will crop up in response to a trigger.
In general, most types of psoriasis result from the same triggers:
Here’s how you can spot the 7 types of psoriasis and what you can do to treat them.
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Is Psoriasis The Same As Eczema
Psoriasis and eczema are two different skin conditions. They differ in where the disease appears on the body, how much it itches and how it looks. Eczema tends to appear more often behind the knees and inside the elbows. Eczema also causes more intense itching than psoriasis. Many people, especially children, can get both eczema and psoriasis.
Can Psoriasis Affect Only My Nails
In some cases, psoriasis may involve only the fingernails and toenails, although more commonly, nail symptoms will accompany psoriasis and arthritis symptoms. The appearance of the nails may be altered, and affected nails may have small pinpoint pits or large yellow-colored separations on the nail plate called “oil spots.” Nail psoriasis can be hard to treat but may respond to medications taken for psoriasis or psoriatic arthritis. Treatments include topical steroids applied to the cuticle, steroid injections at the cuticle, or oral medications.
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What Are Other Types Of Psoriasis
Plaque psoriasis is the most common type. About 80% to 90% of people with psoriasis have plaque psoriasis.
Other, less common types of psoriasis include:
- Inverse psoriasis appears in skin folds. It may look like thin pink plaques without scale.
- Guttate psoriasis may appear after a sore throat caused by a streptococcal infection. It looks like small, red, drop-shaped scaly spots in children and young adults.
- Pustular psoriasis has small, pus-filled bumps on top of the red patches or plaques.
- Sebopsoriasis typically appears on the face and scalp as red bumps and plaques with greasy yellow scale. This type is a cross between psoriasis and seborrheic dermatitis.
Dry Itchy Rash On Elbows
Dry skin on your elbows may result from a variety of conditions, ranging from infections or boils to allergic reactions or dermatitis, according to the American Academy of Family Physicians.
Treatment varies from topical creams to medication and techniques to address the underlying cause of your dry skin.
Dermatitis is a skin condition that causes redness, swelling and itching usually as a result of an allergy to certain fabrics or chemicals that touch your elbows. It causes your skin to break out in blisters and bumps that can be itchy and painful.
When the outbreaks occur primarily on your elbows, you may have a case of dermatitis herpetiformis. This condition is a side effect of gluten sensitivity or a reaction to products containing wheat. Antibiotics help control the dryness and itching
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Steroid Creams Or Ointments
Steroid creams or ointments are commonly used to treat mild to moderate psoriasis in most areas of the body. The treatment works by reducing inflammation. This slows the production of skin cells and reduces itching.
Topical corticosteroids range in strength from mild to very strong. Only use topical corticosteroids when recommended by your doctor. Stronger topical corticosteroids can be prescribed by your doctor and should only be used on small areas of skin or on particularly thick patches. Overusing topical corticosteroids can lead to skin thinning.
What Are The Types Of Psoriasis
In children, common types of psoriasis include:
Plaque psoriasis. This is the most common type of psoriasis. It causes plaques and silvery scales, usually on the knees, elbows, lower back, and scalp. They can be itchy and painful and may crack and bleed.
Guttate psoriasis. This type often shows up after an illness, especially strep throat. It causes small red spots, usually on the trunk, arms, and legs. Spots also can appear on the face, scalp, and ears.
Inverse psoriasis. This causes smooth, raw-looking patches of red skin that feel sore. The patches develop in places where skin touches skin, such as the armpits, buttocks, upper eyelids, groin and genitals, or under a woman’s breasts.
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How Is Psoriasis Treated
Psoriasis is usually treated by a dermatologist . A rheumatologist may also help with treatment. Treatments can include:
- ultraviolet light from the sun or from home or office treatments. But in some children, sunlight can make psoriasis worse.
- creams, lotions, ointments, and shampoos such as moisturizers, corticosteroids, vitamin D creams, and shampoos made with salicylic acid or coal tar
- medicines taken by mouth or injected medicines
A doctor might try one therapy and then switch to another, or recommend combining treatments. It’s not always easy to find a therapy that works, and sometimes what works for a time stops helping after a while.
How To Get Rid Of Red Rash On Elbows
The most important thing when dealing with a rash is not to scratch it. Scratching will only aggravate the condition. Scratching in case of blisters will spread the rash to other skin areas and therefore avoid the same.
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Can A Diet Cure Psoriasis Naturally
- Avoiding environmental factors that trigger psoriasis, such as smoking, and stress may help prevent or minimize flare-ups of psoriasis. Sun exposure may help in many cases of psoriasis and aggravate it in others.
- Alcohol is considered a risk factor for psoriasis, even moderate amounts of beer. People should minimize alcohol use if they have psoriasis. This is especially important if they are taking medications such as methotrexate or acitretin.
- Specific dietary restrictions or supplements other than a well-balanced and adequate diet are not important in the management of plaque psoriasis.
- Recently, some data has supported that an “anti-inflammatory” diet that is high in fruits and vegetables and low in saturated and trans fats may help manage psoriasis, although the value in preventing its onset is less certain.
Evaluation And Differential Diagnosis
Less common variants of psoriasis include inverse psoriasis, pustular psoriasis, guttate psoriasis, erythrodermic psoriasis, and annular psoriasis .6). These variants can be differentiated from the common plaque type by morphology. Differential diagnoses include atopic dermatitis, contact dermatitis, lichen planus, secondary syphilis, mycosis fungoides, tinea corporis, and pityriasis rosea . Careful observation often yields the diagnosis. For more atypical presentations, a skin biopsy might be helpful.
Differential diagnoses and distinguishing clinical features
|DIFFERENTIAL DIAGNOSES||DISTINGUISHING CLINICAL FEATURES|
|Atopic dermatitis||Predominant symptom of pruritus and typical morphology and distribution|
|Contact dermatitis||Patches or plaques with angular corners, geometric outlines, and sharp margins dependent on the nature of the exposure to the irritant or allergen|
|Lichen planus||Violaceous lesions and frequent mucosal involvement|
|Secondary syphilis||Copper-coloured lesions and frequent involvement of palms and soles|
|Mycosis fungoides||Irregularly shaped lesions with asymmetric distribution, peculiar colour, and wrinkling due to epidermal atrophy|
|Tinea corporis||Fewer lesions with annular configuration|
|Pityriasis rosea||Tannish-pink, oval papules and patches with Christmas tree configuration on trunk with sparing of the face and distal extremities|
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Clinical Trials For Psoriasis
Before a new treatment can be registered in Australia it must undergo extensive testing. Clinical trials are used to determine the safety and effectiveness of new treatments for psoriasis. The regulations governing clinical trials in Australia make the process as safe as possible for clinical trial participants. People with psoriasis may consider volunteering to participate in a clinical trial. Participation provides volunteers with access to cutting edge treatments that are not otherwise available. General information about being part of a clinical trial can be found here. Internationally, ClinicalTrials.gov provides patients, their family members, and the public with easy and free access to information on clinical studies for a wide range of diseases and conditions. If you are interested in participating in a clinical trial, talk to your doctor.
What A Dermatologist Evaluates
- Risk for developing other medical conditions
- Response to past treatments for psoriasis
- Concerns about how psoriasis affects your life
- Other medications
Your dermatologist can see the signs of psoriasis during a physical examination of your skin, scalp, and nails, and can take your medical history and symptom history to make an accurate diagnosis.
They will ask you about:
- Symptoms, such as red bumps or itchy skin
- Joint problems, such as pain and swelling or stiffness when you wake up
- Blood relatives who have psoriasis
- Recent changes in your life, such as an illness or increased stress
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What Symptoms Should You Watch For
Visually, it can sometimes be difficult to tell one condition from the other.
You have to look at all the clinical aspects of a rash to distinguish between eczema and psoriasis, including the history and the patients other medical problems, Dr. Fernandez says.
The common signs dry and/or cracked scaly skin, itching and red patches or plaques may show up for either.
With psoriasis, the plaques on your skin are likely thicker and have dry scaling. But sometimes thats not enough to tell between the two with the naked eye, Dr. Fernandez says.
A more obvious clue fluid leaking through the skin points to eczema.
When we see that, we definitely think about eczema instead of psoriasis, he says. But there are definitely times when we cannot tell the difference. And, in those cases, we will perform biopsies.
Sun Exposure In Summer
In the setting of developing this rash on sun-exposed areas, solar dermatitis is the most common diagnosis. Solar dermatitis can have many different causes.
Most commonly among children, this is idiopathic , and can be avoided by avoiding exposure to sunlight or a higher SPF level of sunscreen.
There is a rare form of allergy to sunlight called solar hives or solar urticaria that can be an allergic-type reaction to sunlight, but this is also exceedingly rare. Solar dermatitis in and of itself does not pose any long-term harm, but excessive sun exposure at a young age can be harmful.
An Itching Or Burning Feeling On The Skin
Although psoriasis patches arent usually irritating, some people do report itchiness. People who have psoriasis of the scalp can report its very itchy or dry, says Anthony Rossi, MD, FAAD, a board-certified dermatologic surgeon at Memorial Sloan Kettering Cancer Center and assistant professor of dermatology at Weill Cornell Medical College.
The itching and pain can interfere with basic daily activities including self-care, sleep, and even walking.
What Is Scalp Psoriasis And What Causes It
Psoriasis can appear on any part of the skin, even the scalp. With scalp psoriasis, scalp plaques produce excess scales and can cause your scalp to itch.
Symptoms of scalp psoriasis appear as the following:
- A small bump, called a papule, with a scale on top.
- The plaque typically is covered by thick layers of horny scale. When the scale sheds, it can look like dandruff.
- Sometimes these plaques can itch.
- Scratching these plaques can worsen the condition and lead to what’s called the Koebner phenomenon, or isomorphic response, which can cause psoriasis to develop in areas where there’s inflammation and trauma.
The causes of scalp psoriasis, like all psoriasis, is related to genetic defects that affect the immune system. It is not known if stress causes or makes psoriasis worse.
In some severe cases, scalp psoriasis can cause alopecia, or a loss of hair, which is rare and may be controlled with treatment. Scalp psoriasis can be treated with topical medications, which can sometimes be difficult to apply when the scalp is covered with enough hair that can create a barrier.
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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.