Psoriasis history and symptoms

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Syed Hassan A. Kazmi BSc, MD [2]


The hallmark of psoriasis is a papulosquamouserythematous, scaly rash which can be commonly found on extensor surfaces of the body. Flexural surfaces may also be involved in cases of inverse psoriasis. Patients with psoriasis usually have a history of recent streptococcal throat infectionviral infectionimmunization, use of antimalarial drugs, or trauma. The most common symptoms of psoriasis include pain, which has been described by patients as unpleasant, superficial, sensitive, itchy, hot, or burning (especially in erythrodermic psoriasis and in some cases of traumatized plaques or in the joints affected by psoriatic arthritis). Patients also present with pruritus (especially in eruptive, guttate psoriasis) and high fever (in cases of erythrodermic and pustular psoriasis). Other symptoms include dystrophic nails and long-term erythematous, scaly rash with recent presentation of arthralgia/arthralgia without any visible skin findings. Other extra cutaneous symptoms include redness and tearing of eyes due to conjunctivitis or blepharitis. Avoidance of social interactions is common among patients, especially during the active phase of the disease.


Age of Onset

  • Psoriasis can first appear at any age, though a bimodal distribution of the age of onset is usually observed.
  • The first peak for the development of psoriasis occurs between 20 years and 35 years and the second peak occurs between 40 years and 65 years of age.[1]

Family History

  • Patients with early disease onset often have a positive family history of psoriasis, frequent association with histocompatibility antigen (HLA)- Cw6, and more severe disease.
  • Patients with onset after the age of 40 usually have a negative family history and a normal frequency of the HLA- Cw6 allele.[2]

Initial Presentation

  • A typical psoriasis patient will present with a history of a long-term erythematous, scaly area with ocular and joint involvement depending upon the clinical subtype and chronicity of the disease. There may be multiple relapses and remissions.

Past Medical History

Social History

  • Social history of the patient may indicate smoking, excessive alcohol consumption, and/or a recent stressful event if associated with an acute exacerbation of psoriasis.[4]


Common Symptoms

Common symptoms of psoriasis may include the following:[5]

Less Common Symptoms

Less common symptoms of psoriasis include the following:[6][7]


  1. Swanbeck G, Inerot A, Martinsson T, Wahlström J, Enerbäck C, Enlund F, Yhr M (1995). "Age at onset and different types of psoriasis". Br. J. Dermatol. 133 (5): 768–73. PMID 8555031.
  2. Naldi L, Parazzini F, Brevi A, Peserico A, Veller Fornasa C, Grosso G, Rossi E, Marinaro P, Polenghi MM, Finzi A (1992). "Family history, smoking habits, alcohol consumption and risk of psoriasis". Br. J. Dermatol. 127 (3): 212–7. PMID 1390163.
  3. Ni C, Chiu MW (2014). "Psoriasis and comorbidities: links and risks". Clin Cosmet Investig Dermatol. 7: 119–32. doi:10.2147/CCID.S44843. PMC 4000177. PMID 24790463.
  4. Naldi L, Parazzini F, Brevi A, Peserico A, Veller Fornasa C, Grosso G, Rossi E, Marinaro P, Polenghi MM, Finzi A (1992). "Family history, smoking habits, alcohol consumption and risk of psoriasis". Br. J. Dermatol. 127 (3): 212–7. PMID 1390163.
  5. Ljosaa TM, Rustoen T, Mörk C, Stubhaug A, Miaskowski C, Paul SM, Wahl AK (2010). "Skin pain and discomfort in psoriasis: an exploratory study of symptom prevalence and characteristics". Acta Derm. Venereol. 90 (1): 39–45. doi:10.2340/00015555-0764. PMID 20107724.
  6. "Psoriasis: epidemiology, natural history, and differential diagnosis | PTT".
  7. Kurd SK, Troxel AB, Crits-Christoph P, Gelfand JM (2010). "The risk of depression, anxiety, and suicidality in patients with psoriasis: a population-based cohort study". Arch Dermatol. 146 (8): 891–5. doi:10.1001/archdermatol.2010.186. PMC 2928071. PMID 20713823.

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