What are the signs & symptoms?

Without effective treatment, psoriasis will be likely to continue to have a negative impact on your quality of life. In a survey, nearly 80% of people with psoriasis reported that psoriasis had a strong negative impact on their lives, both physically and mentally. Psoriasis causes red, scaly skin, usually in distinct patches or ‘plaques’. These patches can occur anywhere on your body depending on the type you have. The more accurate the information you give your healthcare team, the easier it will be to find the treatment that works best for you. Keeping a symptom diary will help you and your healthcare team to improve your quality of life. A symptom diary will help you to note how you feel and any times that you forgot to take your medication, as well as any interventions/routines that appeared to provide more relief.

1. Plaque psoriasis

   It is most common on your knees, elbows, scalp and lower back. The patches are usually symmetrical on your body, i.e. on both knees or both elbows. About 50% of people with plaque psoriasis may also have thickened and pitted fingernails and toenails.

2. Guttate psoriasis

   The small spots, like a rash, may appear on your stomach, arms and legs. The soles of your feet and the palms of your hands are not usually affected.

3. Erythrodermic psoriasis

   Your whole body surface can be affected by skin redness and scaling.

4. Pustular psoriasis

   Pustular psoriasis that only appears on your hands and feet is known as ‘palmoplantar pustulosis’. The area where they appear is also usually red and scaly and may be prone to cracking. Although the patches may be painful, the fluid in the pustules is not caused by infection. Pustular psoriasis is not contagious. About a quarter of people who have palmoplantar pustulosis also have plaque psoriasis.

5. Generalised pustular psoriasis

   Patches of small yellow spots appear on painful, inflamed skin. The spots are not just confined to your soles and palms, but they can appear on other areas of your body too. The spots may spread quickly and you may also feel feverish and unwell.

Complications

Psoriatic arthritis is a long-term inflammatory disease which affects around 30% of people who have psoriasis.  Most often psoriasis is already present before any psoriatic arthritis joint pain develops, but in 15% of cases psoriasis and psoriatic arthritis can start at the same time. It is also possible for psoriatic arthritis to develop without any signs of psoriasis on your skin.

The symptoms of psoriatic arthritis include

• ridging and pitting of your nails
• joint pain
• stiffness
• fingers swelling up (making your fingers look sausage shaped)

The joints of your hands and feet are the most commonly affected areas but some people have inflammation, swelling and pain in other joints including the knees, elbows, hips and spine.

The severity of psoriatic arthritis can vary. Symptoms can be mild and may only involve a single joint but this can develop into a more severe form involving lots of joints if left untreated.

As joint pain may not be the most significant issue for people who have psoriasis, it is important to be diagnosed and treated as early as possible. If you have any of these symptoms or think you might have psoriatic arthritis, see your healthcare team as soon as possible so that you can get appropriate treatment and support.