Psoriasis is characterized by raised areas of inflamed skin and can develop just about anywhere on the body. But different forms of psoriasis tend to appear in certain areas.
Types of psoriasis include:
Plaque psoriasis: The most commonTrusted Source type, plaque psoriasis sometimes develops in a symmetrical pattern over the body. The plaques can look red or pink on lighter skin. They may look purple or dark brown on darker skin. White, silver, or gray scaling is also common.
Inverse psoriasis (flexural psoriasis): This type appears in folds of skin, causing large areas of smooth, shiny skin. Patches can be red or just darker than the surrounding skin.
Guttate psoriasis: Guttate psoriasis is more common among children and young adults and often appears suddenly, with droplet-like spots over a large area. Depending on skin color, spots can be pink, red, purple, or brown.
Pustular psoriasis: With pus-filled blisters (pustules) forming on swollen skin, pustular psoriasis can take on the appearance of an infection.
Erythrodermic psoriasis: This rare and potentially life threatening type can cause widespread redness resembling a burn.
This article discusses where on the body different types of psoriasis are likely to develop.
Psoriasis on the scalp is usually plaque psoriasis, but guttate psoriasis can also affect the scalp. About 80%Trusted Source of people with psoriasis will have scalp involvement at some point. Scalp psoriasis can develop on the:
- hairline
- forehead
- back of the neck
- around the ears
- whole scalp
Signs and symptoms of scalp psoriasis can include:
- extreme dryness
- severe itching
- dandruff-like scaling
- surface cracking and bleeding
- sensations of burning or pain
- hair loss
It may not be easy to apply topical psoriasis medications to the scalp through hair. But there are many over-the-counter and prescription-strength medicated shampoos and other topical treatments you can use. These products may contain coal tar, salicylic acid, or corticosteroids.
Plaque psoriasis and guttate psoriasis can both affect the face. Symptoms of face psoriasis may include:
- itching
- soreness
- overly sensitive skin
The majorityTrusted Source of people with face psoriasis also have scalp involvement. Face psoriasis is most likelyTrusted Source to affect the:
- upper forehead
- lower forehead
- ears or area around the ears
- cheeks
In rare cases, psoriasis may develop in or around the mouth or around the eyes.
Psoriasis in the mouth may cause:
- redness
- burning
- bleeding
- difficulty chewing or swallowing food
You may talk with a doctor and a dentist if you experience any of these symptoms.
Psoriasis around the eyes may cause:
- redness or discoloration
- dryness
- discomfort
- vision impairment
Speak with a doctor about treating psoriasis that affects your eyes. You may need to use extra care when applying topical treatments near the eye.
Plaque psoriasis can develop anywhere on the body, including the hands and feet.
About 12% to 16%Trusted Source of people with psoriasis develop it on their hands or feet. This is called palmoplantar psoriasis.
Symptoms of palmoplantar psoriasis include:
- well-defined areas of raised, thickened skin
- redness or discoloration
- fissures or cracks
- pain
- itching or burning sensations
Due to the way palmoplantar psoriasis can impair your ability to use your hands and feet, it may limit mobility, affect your ability to perform certain tasks, and affect your overall quality of life.
In some cases, people may develop pustular psoriasis on their hands and feet. The pustules tend to develop on the palms of the hands and soles of the feet. The surrounding area is usually red or discolored. The pustules gradually develop scales and peel off. New pustules can form every few days or weeks.
Psoriasis on the knees and elbows is usually plaque psoriasis. You can recognize it by the distinct raised plaques of red, purple, or brown skin, along with silver, white, or gray scales. The knees and elbows can feel very itchy or even painful.
Scratching can cause the patches to thicken even more.
Any type of psoriasis can lead to changes in your fingernails and toenails. About 90% of people with psoriasis will experience nail symptoms at some point.
Signs of nail psoriasis can include:
- white, yellow, or brown discoloration under one or more nail
- nails that are thickened, ridged, pitted, or crumbling
- abnormal nail growth
- nail lifting off the nail bed
Psoriasis of the nails may be an indicator of psoriatic arthritis. If you experience these symptoms, you may want to see a doctor to be screened for this condition.
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About 21% to 30% of people with psoriasis have inverse psoriasis, which develops in skin folds such as:
- armpits
- under the breasts
- genital area
- buttocks
It generally involves large areas of inflamed skin that look deep red or darker than the surrounding area. The skin is smooth rather than scaly. Symptoms can include:
- intense itching
- soreness
- burning
- pain
Certain factors such as friction, hot weather, and sweating can make symptoms worse.
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Genital psoriasis affects about 63%Trusted Source of people with psoriasis at some point. Both inverse psoriasis and plaque psoriasis can develop on the genitals.
This type of psoriasis may affect the:
- vulva
- penis
- scrotum
- skin above the genitals
- crease between the genitals and thigh
- crease between the buttocks
- inner and upper thighs
Itching is the most commonTrusted Source symptom of genital psoriasis. Other symptoms may include redness, burning, and pain. Symptoms may worsen during or after sexual intercourse and can impact sexual function.
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Both plaque psoriasis and guttate psoriasis can affect the arms, legs, and torso. With plaque psoriasis, you may notice raised plaques of darkened skin with scales. Guttate psoriasis is easily identified by the small discolored spots.
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Erythrodermic psoriasis is rare, affecting about 1% to 2.25% Trusted Source of people with psoriasis. This type of psoriasis affects the whole body and can be life threatening. Signs and symptoms may include:
- intense redness or discoloration over at least 75%Trusted Source of the body
- scaling
- layers of skin shedding in large sheets
- severe itching and pain
- changes in heart rate
- fever
- chills
- dehydration
- nail changes
- hair loss
Generalized pustular psoriasis (von Zumbusch psoriasis) is also rareTrusted Source and potentially life threatening. It can come on suddenly, with pustules forming over much of the skin. Within a day or so, the pustules break and leak pus onto the skin. Within another day or two, the skin dries out and peels, leaving a smooth surface.
Other symptoms may include:
- fever
- muscle weakness
- fatigue
- nausea
- tremors
These types of psoriasis require immediate medical attention.
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Treatment options for psoriasis depend on many factors, such as:
- type and location of the psoriasis
- severity of symptoms
- co-existing conditions, such as psoriatic arthritis
Psoriasis is a chronic condition, which means long-term therapy may be necessary. In mild to moderate cases, topical therapy may be enough to manage your symptoms. Topical treatment options include:
- moisturizers, ointments, and creams
- medicated shampoos
- treatments containing coal tar or salicylic acid
- corticosteroids
- anthralin
- retinoids
- vitamin D-based medications
- aryl hydrocarbon receptor agonists
- phosphodiesterase-4 (PDE4) inhibitors
Light therapy (phototherapy) can also help treat psoriasis. This involves regular exposure to ultraviolet light. A doctor can provide this treatment in the office, or you may get a prescription for a phototherapy unit to use at home.
If you have widespread or severe psoriasis, you may also need a systemic treatment. This can be in the form of oral medication, injections, or infusions such as:
- acitretin, a synthetic retinoid
- immune system suppressants such as methotrexate and cyclosporine
- biologics, which target specific parts of the immune system
- JAK inhibitors, which target specific enzymes involved in the immune response that leads to psoriasis
You can work with a doctor to develop a treatment plan that’s right for the specific type of psoriasis you have.
Psoriasis is an inflammatory skin disorder that can develop anywhere on the body. Some types of psoriasis are more likely to occur in certain areas of the body than others.
It’s usually a lifelong condition. But a growing number of effective treatment options, including local and systemic medications, can help you manage your psoriasis.
