What Does a Psoriasis Rash Look Like?

Psoriasis is a life-long skin disorder that causes rashes. While not contagious, psoriasis rashes are frequently itchy and painful. The most common type, plaque psoriasis, starts out as small red bumps that grow larger and form a scale.

Scratching the rash can pull scales off the skin and cause bleeding. As the rash spreads, bumpy red and silvery-scaled patches on the skin can develop.

Psoriasis can take hold anywhere on the body where there is skin. It is most often found on the knees and elbows, or on the scalp.

Contents of this article:

Types of psoriasis

Symptoms and complications

How can rashes differ in severity and in different areas?

How to tell a psoriasis rash from different kinds of rash

Treatments and home remedies

Causes of psoriasis

Types of psoriasis

There are several different types of psoriasis.

[plaque psoriasis]

Plaque psoriasis is the most common type of psoriasis.Plaque psoriasis

This is the most common form. According to the American Academy of Dermatology, 80 percent of the 7.5 million Americans with psoriasis have this form.

It usually produces red patches of plaque, with a silvery-white coating of scale. It commonly appears on the scalp, the lower back, the elbows, and the knees. The patches can be sore and itchy, and they can get thicker if scratched.

Finger and toenails may also develop pits, or they may crumble or fall off.

Pustular psoriasis

Pustular psoriasis gives rise to painful, pus-filled bumps that are usually found on the palms of the hands and the soles of the feet. The skin surrounding the bumps is swollen and red.

When the bumps dry, they leave behind brown spots that may be covered with scale. Individuals with this condition may also develop a fever, chills, weak muscles, little appetite, extensive itching, and tiredness.

Inverse psoriasis

This form only appears in areas where skin is in contact with skin, or skin folds, including the armpits, behind the knees, the groin, the buttocks, the genitals, and under the breasts. The skin is very red, shiny, raw, and sore.

Guttate psoriasis

This form often develops after an illness, like strep throat.

Guttate psoriasis is identified by small red spots that form all over the body, most often on the chest, legs, and arms.

Found in about 10 percent of people with psoriasis, according to the National Psoriasis Foundation, guttate psoriasis can affect children and young adults, as well as those somewhat older.

Erythrodermic psoriasis

Erythrodermic psoriasis is a rare and very serious condition. Individuals who develop symptoms should seek medical treatment immediately.

With the skin turning red, this condition looks like a burn over most or all the body. It is accompanied by intense pain and itching and a very rapid heartbeat.

Individuals may feel very hot or very cold, because it is not possible for the body to maintain a stable temperature.

Symptoms and complications

Psoriasis affects individuals in different ways, and it can take multiple forms, but people with all types of psoriasis typically have at least one of the following symptoms:

[guttate psoriasis]

Guttate psoriasis can occur after a strep infection.

Itchy, sore, or burning patches on the skin

Red patches of skin, with silvery spots

Small red spots on the skin

Dry, cracked skin

Changes in the nails

Swollen joints.

Most forms of psoriasis typically go through phases. Symptoms may become more severe for an extended period of time, and then improve or disappear.

The following factors can trigger a flare-up of psoriasis:

Skin injury

Infections

Medications such as lithium, beta-blockers, iodides, and antimalarials

Stress

Cold temperatures

Exposure to smoke

Heavy use of alcohol.

Psoriasis is a life-long condition, but it can usually be managed effectively with over-the-counter treatments and medication.

However, it is also linked to the following complications:

Psoriatic arthritis can develop in about 30 percent of people with psoriasis, and it often affects the joints closest to the fingernails and toenails

Cardiovascular disease may be linked to severe cases of psoriasis

Onychomycosis is a fungal infection experienced by around one third of those with psoriasis. It makes the nails grow thicker.

Psoriasis also seems to increase the risk of developing other serious health conditions. These include other autoimmune diseases, depression, kidney problems, and Parkinson's disease.

How can rashes differ in severity and in different areas?

Psoriasis on the face can be challenging. The skin is very sensitive in this area, as are the eyes, so great care should be taken with treatment, even with mild cortisone creams.

Psoriasis may also develop on the eyes, in the ears, and around the mouth and nose.

When the hands and feet are affected, swelling, blisters, and cracking may follow. Prompt and cautious treatment is recommended. Phototherapy, combined with medication, may be an effective treatment.

With more severe cases, such as those involving pustular psoriasis, a biologic drug may be used.

About half of all individuals with psoriasis develop problems with their nails.

[nail psoriasis]

Nail psoriasis can cause the fingernails or toenails to crumble and break off.

These can include:

Changes in the shape or color

Thickening or developing holes

Separation of the nail from the nail bed.

Psoriasis on the scalp ranges from the mild to the severe. Plaque lesions may grow beyond the boundary of the hairline to reach the ears, forehead, and the neck.

The National Psoriasis Foundation report that close to 50 percent of individuals living with psoriasis develop sores at this location.

Psoriasis in the genital area affects some of the body's most sensitive skin, so particular care needs to be taken with treatment.

This is usually caused by the inverse variety of psoriasis, so it is not scaly but it can result in tender, sensitive skin.

How to tell a psoriasis rash from different kinds of rash

Eczema, another skin disorder that causes itching and discomfort, can be mistaken for psoriasis, but in a biopsy, skin affected by psoriasis will look thicker and redder than skin affected by eczema.

Shingles, a rash caused by the same virus that causes chicken pox, forms itchy, painful blisters on one side of the body. One notable difference with psoriasis is that the area where the rash develops will often feel uncomfortable before the rash appears.

Heat rash can cause itchy red blisters in skin folds. It may at times be confused with psoriasis. Physicians can make an appropriate diagnosis with a simple examination.

Other conditions that cause similar-looking rashes

The following conditions also resemble psoriasis:

Lichen planus can appear on the skin as reddish bumps, or as white dots in the mouth

Pityriasis rosea starts with a "herald patch" on the trunk, with smaller itchy patches spreading across the body in a shape frequently described as resembling a pine tree

Ringworm, caused by a fungus, forms a circle-shaped itchy red rash

Seborrheic dermatitis is an itchy, red skin condition usually found on the scalp and other oily areas of the body.

When to see a doctor

People should see a doctor if a skin rash lasts longer than a few days, if it interferes with their quality of life, or if there are other symptoms, such as a fever.

Treatments and home remedies

Various treatments are available for psoriasis. Treatment decisions are based on the form of psoriasis, the location of the rash, the severity, and its impact on the individual.

The most common approaches include:

Exposure to sunlight

Soaking with bath oils or tar solutions

Using moisturizers to keep the skin from cracking

Covering rash areas

Rest

Lotions and creams, such as coal tar ointments, topical steroids, and compounds based on vitamin D or vitamin A

Light therapy

Oral medications

Injected medications.

Individuals sometimes use superglue to manage deep cracks in the feet due to psoriasis. Patients should check with a doctor first, to make sure this action would be safe, and that the patient is not allergic.