Psoriasis: Different Types

Published by Dr Hanish Babu, MD, Dermatologist & Venereologist, City Medical Centre Ajman and Cosmolaser Medical Centre, Sharjah, UAE.

Classifications of Psoriasis

Psoriasis is classified into various types depending upon the morphology (appearance), clinical types and severity and extent of the disease.

Types of Psoriasis
Types of Psoriasis

1. Morphological Classification of Psoriasis

This classification depends upon the appearance of skin lesions:

  • Guttate Psoriasis: Rain drop like lesion, sudden onset, seen usually in children.
  • Plaque Psoriasis (Psoriasis vulgaris): The common raised patch (plaque) variety
  • Inverse Psoriasis (Flexural Psoriasis): Involves the body folds like axilla, groin, below the breasts and in between the buttocks.

2. Life Style: Quality of Life

Psoriasis can also be classified depending upon how patient’s life style or quality of life is affected by the disease.

Mild Psoriasis
  • Disease does not alter the patient’s quality of life. 
  • Patients can minimise the impact of disease and may not require treatment.
  • Treatments have no known serious risks (e.g., class 5 topical steroids). 
  • Generally less than 5% of body surface area is involved with disease.
Moderate Psoriasis
  • Disease does alter the patient’s quality of life.
  • The patient expects therapy will improve quality of life.
  • Therapies used for moderate disease have minimal risks
  • Generally between 5% and 20% of body surface area is involved with disease.
Severe Psoriasis
  • Disease alters the patient’s quality of life.
  • Disease does not have a satisfactory response to treatments that have minimal risks.
  • Patients are willing to accept life-altering side effects to achieve less disease or no disease.
  • Generally more than 20% of body surface area is involved with disease.
Other factors that may affect the Severity Classifications are:
  • Patient’s attitude about disease
  • Location of disease (eg, face, hands, fingernails, feet, genitals)
  • Symptoms (eg, pain, tightness, bleeding, or severe itching)
  • Arthralgias (joint pain) / arthritis (joint inflammation)

3. Clinical Staging

  1. Acute Eruptive Psoriasis: This is the guttate variety which suddenly appears all over the body and spreads fast.
  2. Chronic Progressive Psoriasis:  The common plaque psoriasis, also known as psoriasis vulgaris, with a progressive clinical course.
  3. Chronic Stationary Psoriasis: When the psoriasis lesions remain stationery without increasing in size and with a dull red colour and minimal scaling, this is a stationary stage. This stage usually precedes the regressive stage.
  4. Chronic Regressive Psoriasis: With or without treatment, psoriasis lesions gradually become thin, scaling reduces, the red color changes from dull red to violaceous and gradually fade. In those who have used steroids or ultraviolet radiation, a hypopigmented (whitish) ring known as Woronoff’s ring may be seen surrounding the lesion.

Several other methods exist for measuring the severity of psoriasis. These scales are generally based on the following factors: the proportion of body surface area affected; disease activity (degree of plaque redness, thickness and scaling); response to previous therapies; and the impact of the disease on the person.

The Psoriasis Area Severity Index (PASI) is the most widely used measurement tool for psoriasis. PASI combines the assessment of the severity of lesions and the area affected into a single score in the range 0 (no disease) to 72 (maximal disease).

Read more about Psoriasis:

Disclaimer

The information given in this article is for educational purpose only so that patients are aware of the options available for diagnosis and treatment of common skin, hair and nail diseases. No diagnosis should be made or treatment undertaken without first consulting your dermatologist. If you do so, the author will not be responsible for any consequences. The images provided are for illustration purpose only and should not be reproduced without the consent of the author.

About the Author of Skin Care Tips from Dermatologist: Dr Hanish Babu, MD
Dr Hanish Babu, MD, Dermatologist, Sharjah and Ajman, UAE
Dr Hanish Babu, MD

Dr Hanish Babu, MD is a dermatologist with more than 3 decades of experience in treating skin and sexually transmitted diseases in UAE and India. He has been practicing in UAE since last 22 years. He is a respected speaker during the Continuing Medical education Programmes for doctors, medical students and paramedical staff and is also a Stress Management Trainer. He organises group therapy sessions for patients with psoriasis, eczema and vitiligo.

He is available for consultation at Cosmolaser Medical Centre in Samnan, Sharjah (06 5678 200) from 10 am – 2 pm and at City Medical Centre, Al Bustan, Ajman (06-7 441 882) from 4.30 pm – 9.30 pm.

Visit his personal website  dr-hanishbabu.com for more details and for educational articles on Skin, hair, nail and sexually transmitted diseases. Click here to Book an Appointment with dermatologist Dr Hanish Babu, MD