What is Psoriasis?

Question

What is psoriasis? Why did it take so long for my son to be diagnosed?

Dr. Greene's Answer

Any child with a chronic or recurrent rash that is unresponsive to prescribed treatment deserves a trip to a pediatric dermatologist. With psoriasis, most kids have seen several doctors, even dermatologists, before the diagnosis is confirmed. Psoriasis is often not even considered in children because the average age of onset is 28 years (Dermatology Clinics, 1998; 16:593-608). Also, at least five different patterns of the psoriasis rash exist, all of which look quite different, adding to the likelihood of a missed diagnosis.

The five recognized forms of psoriasis include:

  • Guttate, in which the skin looks as if a hot liquid has splattered on it.
  • Plaque, the most common, with raised red patches and silvery scales.
  • Inverse, in which the rash is mostly on flexion creases, such as the inside of the elbows.
  • Erythrodermic, with sheets of reddened, scalded-appearing skin.
  • Pustular, with multiple little pimples.

One or more of these forms can appear simultaneously in a person with psoriasis, and the disease can shift from one form to another.

Although psoriasis is a long-term, recurrent problem for most who have it, the extent of the problem varies from quite mild to quite debilitating. It might be only a mild scalp condition, easily controlled with the appropriate, over-the-counter shampoo. It might show up as temporomandibular joint disease (TMJ), geographic tongue, or pitted nails. Or, for 10% to 20%, , it might include the swollen hands and feet of psoriatic arthritis.

Medical Review on: June 29, 2014
About the Author
Photo of Dr. Alan Greene
Dr. Greene is a practicing physician, author, national and international TEDx speaker, and global health advocate. He is a graduate of Princeton University and University of California San Francisco.
Get Dr. Greene's Wellness RecommendationsSignup now to get Dr. Greene's healing philosophy, insight into medical trends, parenting tips, seasonal highlights, and health news delivered to your inbox every month.
No comments yet. Start the conversation!
Add your comment