Patchy Rash? Is It Plaque Psoriasis?

What Is Plaque Psoriasis?

Psoriasis is a chronic autoimmune condition in which your body’s immune system mistakenly attacks healthy cells. Around 80-90% of people with psoriasis have the form called plaque psoriasis. In plaque psoriasis, those misdirected immune responses cause your body to produce new skin cells at a far faster rate than normal. The accumulation and shedding of those skin cells causes a rash that appears in patches or plaques on your skin.

Symptoms of Plaque Psoriasis

The most noticeable symptom of psoriasis (and usually the symptom that leads to a diagnosis) is the plaques. Plaques are patches of skin that are red, itchy, painful, scaly, and dry. They can look different from person to person. In Caucasian people, plaques are usually pink or red with white scaling on top, while plaques in people of colour are more often purple or dark brown with silvery scaling.

Plaques most often show up on your elbows, knees, trunk, or scalp, although they can appear anywhere on your body. They may also come and go or have a severity that is up and down. They also tend to be somewhat symmetrical, showing up in the same areas on both sides of your body.

What Causes Plaque Psoriasis?

While medical researchers have long searched for a clear cause of plaque psoriasis, the definitive cause has yet to be found. We know it has a genetic component, so most likely, some people are genetically predisposed to psoriasis, and a trigger in their environment causes them to actually develop the condition. We also know that plaque psoriasis and other types of psoriasis are not contagious.

Psoriasis plaques tend to come and go in waves. The condition itself is always there, but the symptoms go through cycles of flare-ups and remission. Symptoms can flare up or get worse in response to certain triggers. Those triggers are different from person to person, but the most common ones include:

• Infections like the common cold or the flu
• Cold, dry weather
• Skin injuries like cuts, scrapes, sunburns, or bug bites
• Stress
• Heavy drinking
• Smoking or exposure to secondhand smoke
• Certain medications like high blood pressure medications and lithium
• Withdrawal from corticosteroids

Potential Complications of Plaque Psoriasis

Plaque psoriasis is a difficult condition to live with day to day because it affects not only your physical comfort but your appearance, so it can impact your social and emotional health.

Fortunately, plaque psoriasis is not life-threatening, nor does it typically lead to serious medical problems. The most common complications that come from plaque psoriasis include:

• Psoriatic arthritis
• Skin pigment changes where plaques have occurred
• Eye irritation
• Symptom-related mental health issues like social isolation and poor self-image

While most of the direct effects of plaque psoriasis are not serious, people with plaque psoriasis do appear to have a higher risk for some serious health conditions, such as:

• High blood pressure
• Type 2 diabetes
• Obesity
• Cardiovascular disease
• Other autoimmune conditions

Fortunately, psoriasis is far from the only factor involved in these conditions. Plaque psoriasis may raise your risk, but there are many other ways to lower your risk for these illnesses.

Treatments for Plaque Psoriasis

If you are diagnosed with plaque psoriasis, what does the road ahead look like? There is no known cure for plaque psoriasis, so treatments are aimed at reducing and managing your symptoms so it has as little impact on your life as possible. There are numerous treatment options available, and your dermatologist can choose the best fit for you depending on your symptoms, severity, medical history, and other factors.

Topical Medications

Some treatments for plaque psoriasis are applied directly to your plaques. There are several types of prescription topical medications that work in different ways. For instance, corticosteroids can reduce the inflammation and discomfort of your plaques, synthetic vitamin D slows the excess cell growth, and calcineurin inhibitors reduce scaling. Retinoids and salicylic acid can improve psoriasis plaques as well.

Light Therapy

Light therapy is a rather unique and often successful way to treat plaque psoriasis. A dermatologist or other experienced healthcare provider exposes your affected skin to controlled amounts of specific wavelengths of light. In some cases, they will use a photosensitizing product or another topical medication as part of the light therapy. The right amounts and types of light exposure can slow your excess cell growth to minimize your plaques.

Systemic Medications

In addition to topical medications and noninvasive light therapy, some people with plaque psoriasis see improvement with certain systemic medications (internal medications that are either oral or injectable). These can include steroids injected into plaques, oral retinoids, and biologics that change your immune responses because, remember, psoriasis is an autoimmune condition at its core.

Ways to Manage and Minimize Your Psoriasis Symptoms

Plaque psoriasis is a condition that needs to be treated by a knowledgeable, experienced, specialized healthcare professional. In addition to keeping up with your doctor’s treatment plan, though, there are other ways you can help minimize and manage your symptoms. Make these strategies part of your daily routine.

Understand and Track Common Triggers

While plaque psoriasis doesn’t go away, keeping your triggers to a minimum can help you spend more time with your symptoms in remission. Those triggers vary from person to person, so you have to start by finding out what your top triggers are.

Start keeping a journal, tracking any potential psoriasis triggers – cuts and scrapes, sunburns, colds, heightened stress, and so on. Keep track of your flare-ups, too, including how light or severe your symptoms are each day. Look for patterns in your journal – you might notice that you always seem to have flare-ups soon after a particular trigger happens.

Once you have done this and determined what your top triggers are, you can find ways to avoid them as much as possible. Maybe that involves being more conscientious about your sunscreen, practicing stress relief techniques when your stress level rises, and so on.

Calming Skin Care

Even in the midst of a plaque psoriasis flare-up, you can lower your discomfort by using skin care techniques and products that are designed to soothe irritated skin. Try bathing in lukewarm water and washing your skin with gentle soap without scrubbing. You can add some Epsom salts or oatmeal to the bathwater too for a soothing soak.

Skin Hydration

Plaque psoriasis causes your skin to be not only inflamed and irritated but severely dry as well. Being more strategic about your skin’s hydration on a daily basis can go a long way toward improving your skin’s comfort and appearance. Apply a soothing moisturizer daily immediately after your shower or wash your face. You can also use a humidifier if you’re in a climate or season with dry air.

What to Do If You Have or May Have Plaque Psoriasis

Plaque psoriasis can be alarming when it first appears because you don’t know why these frequent and significant rashes are appearing. With proper medical care, though, many people with plaque psoriasis enjoy milder symptoms in the long term.

If you believe you may have plaque psoriasis or if you have plaque psoriasis and want your best treatment options, schedule an appointment with SRx’s integrated team of specialized healthcare services. To help you prepare for your appointment, the Canadian Psoriasis Network has a helpful virtual care guide.