Early Signs and Symptoms of Psoriasis
Medically reviewed by Brendan Camp, MD
Early signs of psoriasis include raised, thick patches of dry skin and discoloration. Psoriasis is an autoimmune disorder that speeds up the growth of skin cells.
The skin cell cycle is relatively long: It takes nearly one month for a skin cell to fully grow, move to the skin's surface, and then fall off. Skin cells can grow within just three or four days in people with psoriasis. The skin cells pile up instead of shedding and cause inflamed patches and scales on your body.
People of any age can experience psoriasis. Symptoms typically peak between women aged 20 to 29 and 50 to 59 and men aged 30 to 39 and 60 to 69. Researchers do not know the exact cause of the skin condition. A combination of genetics and immune system function may lead to the onset of symptoms.
There are five primary types of psoriasis:
Plaque psoriasis
Guttate psoriasis
Inverse psoriasis
Erythrodermic psoriasis
Each type comes with its own set of symptoms. You can also have more than one type of psoriasis at the same time. Your treatment plan will vary depending on the type of psoriasis and the symptoms you are experiencing.
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Related: Signs and Symptoms of Staph Infection
Plaque Psoriasis Symptoms
Plaque psoriasis is the most common type and accounts for 80% to 90% of all cases. Symptoms of plaque psoriasis include:
Dry or cracking skin
Inflamed patches, or "plaques," on the skin that appear pink or red on lighter skin tones and purple or brown on darker skin tones
Itchiness
White, silver, or gray-colored scales
Plaques can develop on any part of the body but typically appear on the knees, elbows, scalp, and lower back. Plaques are often symmetrical, showing up in the same areas on the left and right sides of your body. The size of plaques may also vary between small and large.
People with plaque psoriasis may be more likely to notice symptoms on their nails. This subtype of plaque psoriasis is called nail psoriasis. Nearly 50% of people with plaque psoriasis also have nail psoriasis.
The most common symptoms of nail psoriasis include:
Deformities: Changes to the shape of the nails
Discoloration: A yellow, red, or brown hue in the nails
Onycholysis: A process that causes separation between your nail and your nail bed
Pitting: Holes in the nails that can be shallow or deep
Thickening: Nails may become chunky or dense
Nail psoriasis is more common in the fingernails, but you may also notice symptoms in your toenails. Symptoms can sometimes cause pain and make it difficult to complete hand-related tasks (e.g., picking up items or typing) or walk.
Guttate Psoriasis Symptoms
This type of psoriasis generally affects up to 8% of people with the skin condition. Guttate means "drop-like" papules or plaques.
People with guttate psoriasis may notice symptoms like:
Inflamed and raised skin
Pink, red, or brown spots that appear on the arms, legs, torso, or back
Small and round lesions called papules
Guttate psoriasis symptoms can appear suddenly and most often affect children, but it can develop at any age. Infections like chickenpox or strep throat most often lead to the onset of guttate-type symptoms.
Inverse Psoriasis Symptoms
About 21% to 30% of people with psoriasis have the inverse type. Inverse psoriasis causes inflammation and patches in areas where your skin rubs against itself (skin folds), such as the underarms, breasts, and groin.
Skin folds tend to be more moist than other parts of your body. Inverse psoriasis patches are not raised or scaly but are smooth. Symptoms may worsen when you sweat, have deeper skin folds, or wear clothes that cause friction.
Patches may appear:
Dark red, purple, or brown on darker skin tones
Pink or red on lighter skin tones
Raw or sore
Smooth or glistening
Pustular Psoriasis Symptoms
This type of psoriasis is rare and affects only 3% of people with psoriasis. Symptoms of pustular psoriasis include:
Bumps that feel painful or hard
Pus-filled bumps called pustules
Pustules that are surrounded by inflamed and discolored skin patches
White or yellow-colored liquid or pus in the lesions
Pustules most often appear on smaller parts of the body, such as your fingers, palms of your hands, and toes. Pustular psoriasis may disrupt activities that involve the hands and feet, such as walking, doing chores, or driving.
Erythrodermic Psoriasis Symptoms
Only 2% of people with psoriasis have this psoriasis, the rarest and most severe type. Erythrodermic psoriasis causes symptoms on the entire body and can be life-threatening.
Erythrodermic symptoms may include:
A large amount of skin peeling or shedding
Fluctuating body temperature (e.g., feeling very hot then suddenly feeling very cold)
Inflamed and scaly patches that cover the entire body
Rapid heart rate
Red or brown-colored rash
This type of psoriasis does not develop on its own. People with erythrodermic psoriasis typically start with a less severe form of psoriasis. You may be at a high risk of erythrodermic psoriasis if your body doesn't respond to treatment, which causes symptoms to worsen.
If you notice symptoms of this type of psoriasis, seek medical care immediately. If untreated, erythrodermic psoriasis can cause complications, such as dehydration or heart failure.
When To See a Healthcare Provider
Psoriasis can sometimes mimic symptoms of other skin conditions, such as dermatitis (eczema). It's a good idea to reach out to a healthcare provider if you notice changes to your skin or think you may be at risk for psoriasis. Keep track of where you have symptoms and how long you have had them, as well as if you have skin patches, discoloration, or inflammation.
A healthcare provider or dermatologist (a healthcare provider who specializes in the skin) can complete a physical exam. They may order other tests to determine what is causing skin changes.
Related: Signs and Symptoms of Leprosy
A Quick Review
Psoriasis symptoms tend to vary based on the type you have: plaque, guttate, inverse, pustular, or erythrodermic. Symptoms typically occur when your body speeds up the growth of new skin cells, causing them to pile up and develop patches, scales, or lesions. These patches are generally accompanied by inflammation and discoloration.
Don't wait too long to get tested. Keeping track of your symptoms and visiting a healthcare provider as soon as possible can help you get an early diagnosis. They can offer you treatment options to help you manage the skin condition.
FAQs
Frequently Asked Questions
1. What are the early signs of psoriasis?
A skin rash is one of the early signs of psoriasis. You might have raised skin patches or silvery scales. These patches are typically red in people with lighter skin tones and purple or brown in people with darker skin tones. You may also develop dry, itchy skin.
2. Is psoriasis an early sign of HIV?
People with HIV typically have psoriasis symptoms that do not respond to treatments. Keep in mind that a psoriasis diagnosis does not always mean you also have HIV. It's important to see a healthcare provider for testing if you think you've been exposed to the virus.
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