Psoriasis: Signs & symptoms

The symptoms of psoriasis depend, most importantly, on the type and location. Plaque psoriasis is the most common type of psoriasis with the following signs & symptoms:

• Rounded red or oval spots lined with white or silver scales. Their size is variable ranging from small patches to large plaques that can cover a large body surface. The most typical locations are the elbows, knees, lower back area and scalp but can also appear in any area of the skin.
• Itching. Itching is one of the most frequent symptoms of psoriasis patients, and it may have a bigger impact on quality of life than the visible effect of the disease.
• Burning, pain or bleeding.

Another typical sign of psoriasis is Koebner’s phenomenon. In this condition, any skin trauma (scratches, burns, etc.) causes psoriasis lesions to appear 2 to 6 weeks after trauma to the skin. It happens to 1 in 4 people with psoriasis.

Other diseases associated with psoriasis include:

• Cardiovascular Diseases (such as myocardial infarction, angina, stroke or peripheral vascular disease). Research continues to link psoriasis and psoriatic arthritis with an increased risk for cardiovascular disease, especially in people with severe psoriasis. The good news is that treating your disease can reduce your risk of heart attack and stroke. Talk to your doctor about your risk for cardiovascular disease.
• Cardiovascular Risk Factors (such as diabetes, dyslipidemia, obesity, and hypertension):
  • People with psoriasis are at an increased risk for type 2 diabetes. People with severe psoriasis, in particular, are 30 percent more likely to have type 2 diabetes. If you have symptoms of type 2 diabetes, such as increased thirst, hunger, blurred vision or fatigue, tell your doctor.
  • There is a significant association between psoriatic disease and metabolic syndrome – a cluster of conditions that include dyslipidemia, abdominal obesity and high blood pressure. A recent study found that 40 percent of those with psoriasis had metabolic syndrome, compared with just 23 percent of the general population. More women with psoriasis had metabolic syndrome than men.
• Inflammatory Bowel Disease (such as Crohn disease, Ulcerative Colitis): There is a connection between psoriasis, psoriatic arthritis and inflammatory bowel disease. In a recent study of women with psoriasis, 10 percent developed a form of inflammatory bowel disease, such as Crohn's Disease or ulcerative colitis. Those who had psoriasis and psoriatic arthritis were at even greater risk of developing Crohn's. People with psoriatic disease and Crohn's share similar genetic mutations. Talk to your doctor if you have symptoms of inflammatory bowel disease such as diarrhea, abdominal cramping and bloody stools.
• Fatty liver. In this disease, fats accumulate in the liver.
• Kidney Disease: People with severe psoriasis are twice as likely to develop chronic kidney disease than those whose psoriasis was mild or had no psoriasis at all.
• Cancer. People with psoriasis are at higher risk of cancer, especially lymphoma, basal cell carcinoma and squamous cell carcinoma.
• Anxiety and depression. Psoriasis is associated with a multitude of psychological impairments. Related psychological problems can affect every day social activities and work. It causes embarrassment, lack of self-esteem, anxiety and increased prevalence of depression.

Anxiety and depression can exacerbate psoriasis and reduce overall the quality of life. Therefore, if you notice any symptoms of depression (sadness, apathy, fatigue, difficulty concentrating, etc.) or anxiety (anguish, nervousness, insomnia, etc.), you should talk to your doctor who will help you find a solution.

Additionally, to the associated comorbidity, evidence of associations between psoriasis and certain harmful lifestyle habits, such as tobacco consumption and ⁄ or alcohol consumption.

1. Daudén, .E., Castañeda, S., Suárez, C., García-Campayo, J., Blasco, A J., Aguilar, M.D., Ferrándiz, C., Puig, L., Sánchez-Carazo, JL. Clinical practice guideline for an integrated approach to comorbidity in patients with psoriasis. JEADV [Internet]. 2013 Nov;27(11):1387-404. Available at: https://www.ncbi.nlm.nih.gov/pubmed/23134338. doi: 10.1111/jdv.12024.
2. Daudén, .E., Castañeda, S., Suárez, C., García-Campayo, J., Blasco, A J., Aguilar, M.D., Ferrándiz, C., Puig, L., Sánchez-Carazo, JL. Position statement for the management of comorbidities in Psoriasis. JEADV [Internet]. 2018 Dec;32(12):2058-2073. Available at: https://www.ncbi.nlm.nih.gov/pubmed/29992631. doi: 10.1111/jdv.15177.
3. Leavitt, M., Why do we itch?. NPF [Internet]. 2016. Available at: https://www.psoriasis.org/advance/why-do-we-itch
4. National Psoriasis Foundation (NPF). Life with Psoriasis [Internet]. 2019. Available at: https://www.psoriasis.org/life-with-psoriasis
5. European Academy of Dermatology and Venereology (EADV). Psoriasis and comorbidities [Internet]. 2019. Available at: https://eadv.org/cms-admin/showfile/9635-EADV%20PSORIASIS-11-Psoriasis%20and%20comorbities.pdf
6. National Psoriasis Foundation (NPF). People with psoriasis and psoriatic arthritis are at an elevated risk of developing other chronic and serious health conditions, also known as "comorbidities." [Internet]. 2019. Available at: https://www.psoriasis.org/about-psoriasis/related-conditions
7. World Health Organization (WHO). Global report on psoriasis [Internet]. 2016. Available at: https://apps.who.int/iris/handle/10665/204417