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Psoriasis on hands, face, feet, and more – Psoriasis

Psoriasis on hands, or psoriasis, is a chronic, autoimmune condition that affects the skin. It can also affect your face, feet, and joints.

Psoriasis is the most prevalent or frequent autoimmune disease in the US. It affects both men and women, but it is slightly more common in women. It can begin at any age, although it is more common between the 20s-30s and the 50-60s year of age. The overall mean age of diagnosis is 28 years old. Despite that, even children can have psoriasis, but this is unlikely. 

In the following reading, you will find the essentials of psoriasis. Also, you will find the answers to common questions like: can psoriasis affect the hands? Is it contagious? And many more. All of this, explained in simple terms by a doctor. Keep reading, so you can find the answers you are looking for. 

What is psoriasis?

Psoriasis is an autoimmune disease that involves skin cells’ impairment. It is a chronic and noncontagious condition. Also, it is considered a complex disease since it has multiple factors that can influence its development.

The main characteristics of psoriasis are areas of abnormal skin. These areas can be red or purple and have itchy scaly patches. They appear most commonly on knees, elbows, trunk, and scalp. But they can appear anywhere in the body, including hands, feet, neck, and forehead. Sometimes, these patches of thick skin can crack and bleed.

Why do people get psoriasis?

Doctors don’t know what causes psoriasis exactly. However, they have identified many key factors that contribute to the development of this condition. The leading causes are basically: genetic factors or immune factors. Sadly, anyone with a family history of psoriasis is much more likely to develop the disease.

On the other side, psoriasis is mainly an autoimmune disease. This means that your immune system attacks cells of your body instead of attacking external agents.

When your immune attack your skin cells, an inflammatory reaction occurs. This speeds up the production of new skin cells. This accelerated process causes the cells to pile up when they get to the skin surface. It thickens the skin and causes the typical skin lesions of psoriasis. Typically, skin cells take a little less than thirty days to replace themselves. In psoriasis, this process speeds up and can take four to five days. 

What are the causes of psoriasis?

As we mentioned before, there is no cause known for psoriasis. It is considered an autoimmune disease, with genetic and immunologic factors related. There are other factors that doctors consider as triggers for psoriasis. The conditions that may cause outbreaks to include:

  • Emotional stress: like any other autoimmune disease, stress is a risk factor for developing psoriasis outbreaks. 
  • Surgery, cuts, or scrapes: or other skin traumas may trigger psoriasis. 
  • Medications: like beta-blockers or antimalarial drugs.
  • Infections: especially streptococcus infections. Strep throat or strep infections on your skin are triggers for psoriasis too. 

What are the symptoms of psoriasis?

The most common symptoms patients experience include: 

  • Patches of skin that are raised, inflamed, and/or raised
  • White or silver plaques in the red patches
  • Redness or soreness around patches
  • Thick nails with tiny white spots, also known as pitting.
  • Itching

However, not all patients experience the same psoriasis symptoms. Depending on the type of psoriasis you have, you can experience some symptoms or others. 

What does psoriasis look like?

There are five basic types of psoriasis. Each one of them has different characteristics, and the psoriasis lesions are different between them. 

Plaque psoriasis or psoriasis Vulgaris

This is the most common type representing 90% of cases of patients with psoriasis. It is also known as chronic plaque psoriasis. They are red, raised plaques, with coverage of silvery-white and scaly skin. These plaques are itchy and appear on elbows, knees, buttocks, and back. It is also the typical form of scalp psoriasis.

File:An Arm Covered With Plaque Type Psoriasis.jpg
Source

Guttate psoriasis

In this type, there are many small, red, or pink papules (or pimples). They appear in large areas, like the limbs and back. This is the type that most commonly occurs after a strep infection. 

File:Guttate psoriasis new image.jpg
Psoriasis on hands
Source

Inverse psoriasis

The lesions are smooth and inflamed patches of skin. They are most common in skin folds like the armpits and the groin. They can appear in other places like upper thighs, under the breasts, and between the buttocks. This is not the typical form of psoriasis. However, patients with inverse psoriasis can have other forms of psoriasis in other parts of their bodies. 

Pustular psoriasis

The lesions in this type of psoriasis are raised bumps filled with pus. They often appear in the hands and feet. These pustules may cover long extensions of your body. When this happens, you may experience red skin and fever, along with weakness and severe itching. 

File:Psoriasis pustules.jpg
Source

Erythrodermic psoriasis

It is a form of severe psoriasis. In this type of psoriasis, a widespread inflammation occurs. There is also exfoliation of the skin that can cover almost the entire body surface. This can cause severe pain and itching. It can emerge from any type of psoriasis. This is a dangerous form of psoriasis because the body may lose its ability to regulate temperature due to severe inflammation.

Nail psoriasis

Psoriasis may also affect the nails. Lesions appear as tiny depressions of the nail. There may also be whitening of the nail, discoloration, and bleeding under the nail. Thickening of the skin under the nail is also common and may result in onycholysis (separation of the nail).

What organs are affected by psoriasis?

The skin is the main organ affected by psoriasis. The skin cells’ exchange process speeds up, causing old cells to build upon the surface of the skin. This is the result of an autoimmune reaction.

Depending on the type of psoriasis, the skin lesions may be different. Also, the locations of the lesion change depending on the type of psoriasis. Your nails could also be affected by psoriasis. 

Psoriasis can also affect your joints. Psoriatic arthritis is a form of chronic inflammation of your joints. It commonly appears with psoriasis in the skin and nails. The chronic inflammation of the joints causes pain and swelling. It can affect almost any joint in your body, especially the ones in your feet and hands. It can also affect big joints like the hip, the spine, and the knees. In most cases, psoriasis will first affect your skin before affecting your joints. 

Can you get psoriasis on hands?

Yes. You can develop psoriasis in any part of your skin. In fact, psoriasis in your hands one of the most common places to develop psoriasis. This form of psoriasis often affects the soles of your feet too. Therefore, it is known as palmoplantar psoriasis. Also, you can develop nail psoriasis, which happens in around 40% of patients with psoriasis. 

What causes psoriasis on hands?

The same autoimmune reaction causes psoriasis on the hands. This speeds up the exchange process of skin cells. This causes your skin to swell, become red and scaly. Your hands are an area with many contacts; this skin can suffer more than the rest of your skin. Remember, skin traumas tend to trigger psoriasis outbreaks; this usually happens with hand and foot psoriasis. Psoriasis on your hands can appear as plaque psoriasis or pustular psoriasis. 

Is psoriasis on hands contagious?

No. Neither hand psoriasis, nor psoriasis per se, are contagious. Remember, psoriasis is a chronic, autoimmune disease. This means that the problem causing the disease is the immune system of the patient. Psoriasis can be hereditary, meaning that you can develop the disease if someone in your family has it. But it is not contagious at all. 

What’s to know about palmoplantar psoriasis?

Palmoplantar psoriasis is the type of psoriasis that affects the palms of your hands (psoriasis on hands) and the soles of your feet. Around 4% of people with psoriasis have palmoplantar psoriasis. It can also appear as palmoplantar pustular psoriasis.

The symptoms of palmoplantar psoriasis include:

  • Raised and thickened skin. The pattern is usually symmetrical in both hands and/or both feet.
  • Scaling of the skin 
  • Redness, itching, and burning sensation 
  • Bleeding and cracking of the skin 

In the case of severe palmoplantar psoriasis, patients may have difficulties to carry out daily activities. Patients can experience severe pain while walking or doing manual work.

The cause of palmoplantar psoriasis is not known. Doctors consider that activities like household or farm work and exposure to chemicals can trigger palmoplantar psoriasis.

What can be mistaken for psoriasis?

A lot of skin conditions can cause symptoms similar to psoriasis. This is why it takes an experienced doctor and a skin biopsy to establish the diagnosis. Some of the conditions that can be mistaken for psoriasis are:

  • Eczema: because of the appearance and itching of the lesions. 
  • Seborrheic dermatitis: a form of eczema that can be mistaken for scalp psoriasis.
  • Fungal infections: like tinea pedis, tinea versicolor, and dermatophytosis. These conditions can mimic palmoplantar, guttate, and inverse psoriasis, respectively. 
  • Lupus: another autoimmune disease. Sometimes it can cause a rash. It is often mistaken for psoriatic arthritis because it also causes pain and swelling of joints.
  • Skin cancer: it is not usual for a doctor to mistake skin cancer for psoriasis. However, skin cancer can cause raised and scaly lesions, similar to the ones of psoriasis.

Do you have psoriasis, or is it eczema?

Psoriasis and eczema are both skin conditions that can be very similar. For an ordinary person, psoriasis and eczema can look exactly the same. Luckily, trained doctors and dermatologists can differentiate them right away.

They are similar because they both cause inflammation and redness of your skin; also, both itch and are very uncomfortable to live with. The most important difference between these conditions is the cause. Psoriasis is an autoimmune disease, while the cause of eczema is not fully understood. Doctors have found that people with eczema don’t have the same protective layer of skin that prevents inflammation and infections.

Another difference is the rash. Even if they look similar, psoriasis affects more commonly the scalp, trunk, front and back portion of the knees and elbows, respectively. Eczema can affect these areas too. However, it tends to appear in the back of your lower limbs and the front of your upper limbs, besides the scalp.

Finally, the itching can be a clue to determine if you have psoriasis or eczema. In psoriasis, the itching tends to be milder. Yet, in cases of severe psoriasis, patients can suffer a painful burn. In eczema, the itching is much more severe, and patients may even scratch their skin until it bleeds. 

How is psoriasis diagnosed?

Most of the time, the diagnosis of psoriasis is pretty simple. The doctors that specialize in skin pathology are the dermatologists. Your doctor will start by asking questions about your medical history and your symptoms. Then, the doctor will perform a physical examination.

Most of the time, a simple inspection of the skin lesions is enough to establish a diagnosis. No further test may be required. However, many skin conditions may be similar to psoriasis. In this case, your doctor may indicate a skin biopsy to rule out other possible diagnoses.

A biopsy is a procedure in which your doctor will remove a small portion of the skin. Then, this tissue is put under the microscope to observe the cells in it. The biopsy of a patient with psoriasis will show the thickening of the epidermis (the most superficial layer of the skin). Also, the cells in this layer appear to be immature because of how quickly they reproduce due to psoriasis. Finally, in psoriasis, inflammatory cells can appear in the sample of tissue.

Laboratory tests are not useful in the diagnosis of psoriasis. However, doctors will indicate them to rule out other diseases that can mimic this condition.

How is psoriasis treated?

There is no cure for psoriasis. Still, there are many treatment options for it. Your doctor will indicate the one that suits you better. For this, they will take into account factors like the type of rash you have, its location, and systemic affectation.

Psoriasis treatment typically includes the following: 

  • Topical treatment: Topical corticosteroids are the most effective psoriasis treatment. Remarkable topical steroids commonly used in psoriasis are betamethasone and triamcinolone acetonide. Yet, topical therapy for psoriasis also includes other tools. Some of them are moisturizing creams for dry skin, Vitamin D analogs, retinol creams, and coal tar. Another option is salicylic acid; it acts as an exfoliant that softens your skin. Your doctor may prescribe a combination of topical medications depending on your case. 
  • Phototherapy: Even in the form of sunlight, phototherapy is another effective way to treat psoriasis. The type of light and time of exposure depends on the psoriasis patient. There are also special lamps that shine a light with a particular length wave to treat psoriasis. UVB therapy and ultraviolet A phototherapy are both useful to treat psoriasis. This therapy works by slowing down the growth of skin cells. 
  • Systemic treatment: Some patients may not respond to topical agents and phototherapy. In this case, doctors may indicate systemic treatment. Psoriasis is an autoimmune disease; therefore, the treatment focuses on drugs that suppress the immune system. Some of these medications include methotrexate and ciclosporin. Other drugs have action to stop the inflammatory reaction in psoriasis, like TNF inhibitors (infliximab) and interleukin inhibitors. 

Do you have psoriasis on hands or any other type of symptoms of this disease?

This tool is a Psoriasis Symptoms Checker. It gathers the most important signs, symptoms, and risk factors for this disease. Therefore, the tool will tell anyone who uses it the likelihood of their symptoms because of psoriasis. Using this tool is free and would only take a few minutes.

What do you think?

Written by Dr. Esteban Kosak

Doctor of Medicine - MD Recently Graduated from Medical School and inspired to aid the global population during this situation. I think that we shall no longer be waiting to see a doctor when we feel sick. Several times we feel disease searches in Google drive us to a rabbit hole and come out thinking that we may die of cancer or something very serious, given that symptoms may seem to fit a wide variety of illnesses. Since I recently graduated from medical school. I have all the medical information fresh in my mind. My thorough experience as an expert researcher allows me to very-well known the different diseases and conditions that affect human bodies. Empowered by the United Nations 17 Sustainable Development Goals (SGDs). I think that we all can provide a grain of sand to help humanity. That's why we created Symptoms.Care a place where you can come and screen your symptoms and find what different illnesses can be related to them. Armed with the right information you can instantly, discretely, secure and from the comfort of your home talk with a Doctor that can Evaluate your Symptoms and help you seek the right treatment.

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