Papules, Scales, Plaques and Eruptions

Picture of Psoriasis 1

Psoriasis: A reddish, scaly rash often located over the surfaces of the elbows, knees, scalp, and around or in the ears, navel, genitals or buttocks. Psoriasis is an autoimmune disease that is mediated by T lymphocytes. It is also a very common disease, Chronic plaque psoriasis affects approximately 2% of people around the world. About 10% to 15% of patients with psoriasis develop joint inflammation (inflammatory arthritis). Treatment options include topical steroid creams, topical vitamin D derivatives, other medications, injections of biologic agents, and exposure to ultraviolet light.

See also: Erythrodermic psoriasis; Flexural psoriasis; Guttate psoriasis; Inverse psoriasis; Plaque psoriasis ; Psoriatic arthritis.

Picture of Psoriasis 2

More than one-quarter of all individuals with psoriasis develop their disease during childhood or adolescence. The degree of involvement is extremely variable; some children develop only a few localized plaques, while others suffer from generalized skin disease and severe arthritis. Pictured are the typical lesions of psoriasis; the plaques have a red-to-orange hue, are scaly, and are sharply demarcated from the surrounding skin. The symmetrical involvement of the knees is a common pattern; elbows and buttocks are other favored locations for plaques like these

Picture of Psoriasis 3

This figure shows the erythema, scaling, and thickening of portions of the thumb and soles that are very common in both children and adults with psoriasis. Therapy of psoriasis is based on the skillful use, either alone or in combination, of a number of therapeutic agents. The most effective are topical steroids, tars, keratolytics, ultraviolet light, and topical calcipotriol and tazarotene in older patients. Children with simple plaque psoriasis can often be managed with short-contact anthralin preparations. When topical steroids are used, it is important to employ the least potent preparation that is effective and to avoid the use of fluorinated steroids on the face and in intertriginous areas. Finally, careful exposure to sunlight during the summer months and artificial ultraviolet light at other times is enormously beneficial in selected patients with extensive involvement.

Picture of Psoriasis Vulgaris

Psoriasis vulgaris, scalp and nail findings. Pinpoint pits and distal onycholysis (so-called “oil-spot” discoloration) are seen in the fingernails of a child with psoriasis.

Psoriasis vulgaris is the medical name for the most common form of psoriasis (“vulgaris” means common). About 80% of people with psoriasis have this type. It is also called plaque psoriasis because of the characteristic plaques on the skin: well-defined patches of red raised skin that can appear on any area of skin, although the knees, elbows, scalp, trunk and nails are the most common locations. The flaky silvery white buildup on top of the plaques is called scale; it is composed of dead skin cells. This scale comes loose and sheds constantly from the plaques. Skin affected with psoriasis is generally very dry, and other possible symptoms include skin pain, itching and cracking.

Picture of Psoriasis Vulgaris Soles

Well-demarcated, erythematous plaques with thick, yellowishlamellar scale and desquamation on sites of pressure arising on the plantar feet; similar lesions were present on the palms.

Picture of Psoriasis Vulgaris Palms

Silvery-white scaly plaque, sharply demarcated, of irregular configuration. On palms and soles the lamellar scales are more adherent than on other parts of the body and only their removal will reveal the reddish inflammatory base.

Picture of Psoriasis Vulgaris Erythematous

Psoriasis vulgaris. Well-delineated erythematous plaque located on the elbow of a child with psoriasis.

Picture of Psoriasis Vulgaris Plaque

Psoriasis vulgaris, Koebner phenomenon. Well-delineated erythematous plaque with a silvery-white scale characteristic of psoriasis.

Picture of Guttate Psoriasis

Guttate psoriasis is a type of psoriasis that looks like small, salmon-pink drops on the skin. The word guttate is derived from the Latin word gutta, meaning drop. Usually there is a fine scale on the droplike lesion that is much finer than the scales in plaque psoriasis, the most common type of psoriasis. The trigger to the disease is often a preceding streptococcal (bacterial) infection. The eruption of the lesions on the skin usually happens about two to three weeks after the person has strep throat. The outbreak can go away and not reoccur.

Picture of Inverse Psoriasis

Inverse psoriasis consists of bright red, smooth (not scaly) patches found in the folds of the skin. The most common areas are under the breasts, in the armpits, near the genitals, under the buttocks, or in abdominal folds. These irritated and inflamed areas are aggravated by the sweat and skin rubbing together in the folds. Yeast overgrowth, common in skin folds, may trigger the skin lesions of psoriasis.

Picture of Pustular Psoriasis

Pustular psoriasis is an uncommon form of psoriasis. People with pustular psoriasis have clearly defined, raised bumps on the skin that are filled with pus (pustules). The skin under and around these bumps is reddish. Pustular psoriasis may cause large portions of your skin to redden. The skin changes that occur before, during, or after an episode of pustular psoriasis can be similar to those of regular psoriasis.

Picture of Erythrodermic Psoriasis

This is the least common type of psoriasis and can be quite serious. A very large area of the body, if not most of the body, is bright red and inflamed. The body can appear to be covered in a peeling red rash. The rash usually itches or burns.

Picture of Psoriasis of the Scalp

The scalp may have fine, dry, scaly skin or have heavily crusted plaque areas. The plaque can flake off or peel off in crusted clumps. Sometimes psoriasis of the scalp is confused with seborrheic dermatitis. A key difference is that in seborrheic dermatitis, the scales are greasy looking, not dry.

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