How to Recognize the Early Stages of Psoriasis

Psoriasis is a chronic inflammatory condition that affects about 7.5 million people in the United States. Currently, there is no cure for psoriasis, but several treatments effectively manage the symptoms. When someone can identify psoriasis early on, they can promptly get treatment to reduce the symptoms and improve their quality of life.

This article will discuss early psoriasis symptoms, psoriasis causes, and triggers. It will also cover how people can get an early diagnosis.

Early Psoriasis Signs and Symptoms

Psoriasis is typically first noticed because of its skin rash. Raised red bumps or plaques with defined edges that develop silver or white skin scales over them are an early sign of the condition. The area can feel dry and itchy as the skin scales develop.

There are different types of psoriasis, each with its own unique signs and symptoms.

Beginning Stages of Different Types of Psoriasis

There are several types of psoriasis. Each type has different symptoms that show up on the skin and elsewhere. There is a description of each type below.

Plaque Psoriasis

Plaque psoriasis is the most common type of psoriasis. About 80–90% of people with psoriasis have this type.

The skin rash is characterized by elevated red areas covered with white or silver skin scales called plaques. The plaques can be of various sizes, and small plaques can combine to form a large plaque. The plaques tend to form symmetrically on the body and are commonly found in the following areas:

• Elbows
• Knees
• Scalp
• Trunk
• Limbs

Guttate Psoriasis

Guttate psoriasis begins with an infection, typically an upper respiratory tract infection like strep throat. It is mostly seen in children.

The symptoms begin with tiny red bumps that cover the legs, arms, and trunk. The bumps can also appear on the face, ears, and scalp.

In some people, guttate psoriasis goes away and never returns. But it is also possible to have guttate psoriasis for life or for the condition to go away and later develop into plaque psoriasis.

Inverse Psoriasis

Inverse psoriasis is a form of psoriasis that shows up in areas where skin touches skin, like the armpits, under the breasts, groin, and crease of the buttocks.

It starts with smooth, red, shiny patches without skin scales. These areas can look raw and be sore or painful. Sweating and rubbing worsen the symptoms.

Pustular Psoriasis

Pustular psoriasis begins with pus-filled swollen bumps that normally show up on the feet and hands. The bumps are surrounded by red skin. When the bumps dry, there may be brown dots and skin scales.

Stress, infection, medications, or chemicals trigger this type of psoriasis.

When pustular psoriasis appears on the whole body, it is called generalized pustular psoriasis (GPP) or Von Zumbusch psoriasis. GPP happens very quickly. It begins with dry, sore, and red skin. Then pus-filled blisters form and cover much of the skin within hours.

Within 24 hours, the blisters break open, and pus oozes onto the skin. When the skin dries, it peels off. This entire sequence can repeat itself after days or weeks.

GPP is very serious and can cause life-threatening complications. The person who has it will feel sick and may have a fever and headache.

Nail Psoriasis

Psoriasis does not only show up on the skin. Approximately half of the people with plaque psoriasis will have nail psoriasis.

Nail psoriasis shows up with the following signs:

• Yellow, brown, or white coloring on the nail
• Small nail dents
• Nails that crumble
• Nails that lift up off of the skin
  

Erythrodermic Psoriasis

Erythrodermic psoriasis is a rare, life-threatening condition typically seen in people with another type of psoriasis.

It starts with a bout of psoriasis that does not get better or worsens. This then transitions to red, scaly skin that looks burned. The person will also feel very sick with fever, chills, muscle weakness, and a fast heart rate.

If someone suspects they have erythrodermic psoriasis, they need to seek immediate care.

Psoriatic Arthritis

About 10–30% of people with psoriasis can develop psoriatic arthritis. It can come on several years after psoriasis begins. Less commonly, psoriatic arthritis can develop before psoriasis shows.

Psoriatic arthritis causes joint pain and swelling. It is often seen in the fingers and toes.

What Causes Psoriasis?

An overactive immune system causes psoriasis. It is an autoimmune condition that causes the body to make too many skin cells. When the skin cells rapidly accumulate, they form plaques on the skin's surface.

Psoriasis is not a contagious condition. It cannot be transmitted to other people in any way.

Can Early Psoriasis Be Cured?

Psoriasis is a chronic condition that cannot be cured. Even if it is caught early, it cannot be cured. Several prescription treatments can lessen symptoms and reduce the incidence of flare-ups. These treatments can include:

• Creams to moisturize the skin
• Phototherapy
• Prescription oral medications
• Steroid creams
• Prescription injection medications

Flare-Up Triggers

Psoriasis is a condition that goes through periods of remission and exacerbations. Several things can trigger a flare-up or worsen psoriasis. These triggers are:

• Stress
• Cold, dry weather
• Skin injuries like a cut or bruise
• Heavy alcohol consumption
• Smoking
• Infection

At What Age Does Psoriasis Usually Start?

Psoriasis can start at any age but tends to have two periods where it usually starts. The first age range is 15–20 years, and the second is 55–60.

When someone develops psoriasis earlier, it is associated with a more severe psoriasis condition. It also tends to run in families, with 36% of people having a family history of psoriasis.

Conditions That Can Look Like Early Psoriasis

Other skin conditions can look like psoriasis. Some of the conditions that can be mistaken for psoriasis are:

• Atopic dermatitis
• Tinea corporis (ringworm)
• Lichen planus
• Contact dermatitis
• Pityriasis rosea

How to Get an Early Diagnosis

The sooner psoriasis is diagnosed, the sooner treatment can begin. Patients need to be advocates in their care and seek a diagnosis from their healthcare provider.

A healthcare provider will examine the rash, nails, and joints to look for signs of psoriasis. They may ask about the patient's medical history and if they have a family history of psoriasis.

If the healthcare provider cannot determine if it is a psoriasis rash, they can scrape the skin for a small biopsy sample.

Summary

Psoriasis is a chronic condition that causes skin rashes, itching, and pain. The symptoms can start with small, raised red bumps and develop into larger scaly patches called plaques. There are multiple types of psoriasis, each with its specific symptoms. Talk to a healthcare provider to get a firm diagnosis and prompt treatment.