Signs and Symptoms of Plaque Psoriasis

The skin symptoms of plaque psoriasis are characterized by areas of dry, inflamed "plaques" usually covered with silvery, flaky scales. They can cyclically worsen and improve over time.

Additionally, the effects can take a psychological toll on people who have the disease. Several medical conditions also commonly affect people who have psoriasis, and these conditions cause additional symptoms along with the symptoms of plaque psoriasis.

Common Skin Symptoms

Psoriasis is mainly characterized by its skin symptoms. Plaque psoriasis is a subtype of psoriasis that causes a specific type and distribution of rash. It is sometimes painful and sore and often very itchy. In fact, “psoriasis” is named from the Greek word “psora,” which means “itchy.” Some people find the itch of psoriasis the most difficult symptom to manage.

Understanding Plaques

The skin changes associated with psoriasis are very specific, and certain patterns differentiate plaque psoriasis from other types of psoriasis. Initially, the skin changes begin as small red bumps. Over time, these small regions coalesce to form larger areas (i.e., plaques). They are generally irregular, but roughly round to oval in shape.

Psoriasis plaques are usually dry and pink to reddish. They are usually covered with a sort of silvery, flaky scale. If the scale is lifted away, the plaque will usually start to bleed. Sometimes these plaques crack, fissure, and bleed, which can be painful.

Affected Body Parts

Plaque psoriasis most often occurs on specific parts of the body such as:

• Elbows
• Knees
• Trunk
• Buttocks
• Scalp

Less commonly, psoriasis can affect other areas of the body, like the face, hands, feet, genitals, or inside your mouth. Usually, these plaques affect both sides of your body in a symmetrical pattern.

Some people might have only a few small spots of skin affected. At the other extreme, psoriasis can affect large areas of skin.

Nail Disease

Many people who initially only have skin symptoms later develop nail problems. This can cause fingernail or toenail changes like the following:

• Separation of the nail from its bed
• Little depressions in the nails (nail pitting)
• Yellow or brown spots on the nail
• Other changes in nail shape

Psoriatic Arthritis

A significant minority of people who have plaque psoriasis also develop symptoms of psoriatic arthritis. Psoriatic arthritis can cause pain, swelling, tenderness, and stiffness of the joints. Almost any joint can be affected, but joints in the hands and feet are common sites.

Usually, joints are affected in an asymmetrical pattern.

Some people have joint symptoms and then later develop psoriasis, and some people with psoriasis later develop symptoms of psoriatic arthritis.

Comorbidity Symptoms

Psoriasis is associated with an increased risk of certain medical conditions.

Some of these include:

• Cardiovascular disease
• Obesity (especially around the waist)
• High blood pressure
• Type 2 diabetes and prediabetes
• Inflammatory bowel disease (such as Crohn’s disease)

These other associated diseases come with their own sets of symptoms.

For some people, living with psoriasis can be emotionally distressing. If you have symptoms of low mood or negative thoughts about yourself, these are just as important to deal with as your skin disease. Don’t hesitate to ask for help if you are struggling with these issues.

Symptom Patterns

Symptoms of psoriasis can begin at any age, but psoriasis most commonly begins in adolescence.

The symptoms of psoriasis often wax and wane over time. A period in which the disease is worse is sometimes called a disease “flare.” After a while, your symptoms may lessen.

Though they may diminish temporarily, symptoms of psoriasis don’t usually go away permanently without treatment. Getting treatment should dramatically reduce your symptoms.

When to See a Healthcare Provider

Psoriasis is not a medical emergency. However, you should see your healthcare provider if your symptoms are not improving as expected with treatment.

Plaque Psoriasis Healthcare Provider Discussion Guid

Get our printable guide for your next healthcare provider's appointment to help you ask the right questions.

Download PDF

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Psoriasis is not an infection. It is not contagious, and you cannot spread it to others.

People with psoriasis may be more likely to get skin infections like cellulitis, especially if their skin is actively irritated. People taking certain types of psoriasis medications are also more likely to get some kinds of infections. Call your healthcare provider if you have symptoms of an infection, like skin warmth, swelling, or a fever.

Some people with plaque psoriasis may have a higher risk of skin cancer, particularly after extensive exposure to PUVA light therapy treatments. See your healthcare provider promptly if you notice any skin changes unlike your normal pattern of psoriasis.