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How Does Psoriasis Start Out?

Ask a Doctor

I’ve recently noticed some patches of dry skin on my arms. Some people in my family have psoriasis and I’m afraid I may have the disease. How does psoriasis start out?

Doctor’s Response

Plaque psoriasis (psoriasis vulgaris), the most common form, usually produces plaques of red, raised, scaly skin affecting the scalp, elbows, and knees. The plaques may itch or burn.

Since psoriasis is a systemic disease of inflammation with dramatic skin involvement, most people should seek medical advice early in its course when symptoms and signs appear. Besides arthritis, people with the condition are more likely to be obese and to have coronary artery disease and/or diabetes. Psoriasis, if limited to small areas of skin, may be an inconvenience for some people. For others, it may be disabling.

Those with psoriasis commonly recognize that new areas of psoriasis occur within seven to 10 days after the skin has been injured. This has been called the Koebner phenomenon.

People should always see a doctor if they have psoriasis and develop significant joint pain, stiffness, or deformity. They may be in the reported 5%-10% of individuals with psoriasis who develop psoriatic arthritis and would be a candidate for systemic (pill or injection) therapy. Psoriatic arthritis can be crippling and cause permanent deformity.

Always see a doctor if signs of infection develop. Common signs of infection are red streaks or pus from the red areas, fever with no other cause, or increased pain.

For more information, read our full medical article on psoriasis.

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References
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