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August marks National Psoriasis Awareness Month, but many people still think psoriasis looks the same on everyone. The reality is far more complex.
At Hines Dermatology Associates in Attleboro, Massachusetts, Yvonne Hines, MD, and our clinical team see patients who’ve been misdiagnosed or treated incorrectly because their psoriasis doesn’t match the “typical” textbook description.
Here’s what you need to know:
Each type of psoriasis behaves differently and responds to different treatments. What works for plaque psoriasis might make pustular psoriasis worse, which is why an accurate diagnosis matters more than most people realize.
The location, appearance, and triggers also vary dramatically between types, making some forms easy to mistake for other skin conditions entirely.
Understanding the five main types helps explain why your symptoms might differ from what you expect and why treatment approaches vary so much between patients. They are:
About 80% of people with psoriasis have this type, characterized by thick, raised patches covered with silvery-white scales. These plaques typically appear on your elbows, knees, scalp, and lower back.
Plaque psoriasis develops when your skin cells reproduce too quickly, taking about 22 days instead of the usual 45 days to reach the surface. The excess cells pile up, creating a thick, scaly appearance.
This type appears as small, drop-shaped spots across your torso, arms, and legs. Guttate psoriasis most commonly develops after streptococcal throat infections, particularly in children and young adults.
Unlike plaque psoriasis, guttate lesions are typically thinner and less scaly. You might even mistake these spots for a viral rash or allergic reaction.
This type develops in areas where skin touches skin — your armpits, groin, under breasts, and around your genitals. Instead of the typical scales, inverse psoriasis appears as smooth, red, inflamed patches.
The lack of scales happens because these areas stay moist from sweat and friction, preventing the typical scale buildup seen in other types.
Although it may look concerning, the pus in pustular psoriasis is made up of white blood cells — not bacteria — so it’s not contagious, just like all other forms of psoriasis.
Localized pustular psoriasis typically affects your palms and soles, creating painful pustules that make walking and using your hands difficult. Patients often describe a burning sensation before the pustules appear.
Generalized pustular psoriasis is more serious, covering large areas of your body with fever and flu-like symptoms. This form can be life-threatening and requires immediate medical attention.
This rare but severe type affects most of your body’s surface with widespread redness and scaling. Your skin loses its ability to regulate temperature and fluid balance, creating potentially dangerous complications.
Erythrodermic psoriasis often develops from poorly controlled plaque psoriasis or can be triggered by stopping corticosteroid medications too quickly.
You may experience intense itching, pain, and temperature fluctuations that require hospitalization.
Many patients come to our office after trying treatments that didn’t work because their psoriasis type wasn’t identified correctly. A proper diagnosis helps us create a treatment plan that addresses your specific condition.
If you’ve been struggling with skin lesions that aren’t responding to treatment, or if you’re unsure about your psoriasis type, Dr. Hines and our team can provide an accurate diagnosis. Call our office in Attleboro at 508-222-1976 today or book your appointment online.
