Symptoms of Psoriasis
- Red patches of skin with adherent hardened silvery skin (scale)
- Well defined red patches of inflamed skin, sometimes with scale
- Small red spots, sometimes with adherent silvery scale
- Painful, dry, cracked skin
- Itching (pruritus), burning or soreness
- Deep red, well defined skin regions with no scale, typically very smooth
- Thickened, pitted or ridged finger or toe nails
Psoriatic arthritis symptoms include:
- Swollen, stiff, and sometimes disfigured joints
Psoriasis patches can range from a few spots of dandruff-like scaling to major eruptions that cover large areas. Psoriasis cases range from mild nuisance to severe cases which can be disfiguring, disabling, and in some cases fatal. Healthcare providers (e.g. dermatologist, skin care specialists) diagnose psoriasis via a number of indicators, and classify it by its type and severity.
Psoriasis is classified as mild, moderate, or severe after consideration of variables typically including:
- Body surface involvement (% of body surface)
- Physical severity (e.g. erythema or redness & inflammation, type and amount of plaque)
- Area of body affected (e.g. hand or foot surfaces may be considered more physically severe)
- Symptoms of pruritus (itching) and pain
- Remission length
- Presence of arthritis
- Quality-of-Life (QoL) Score
Most assessments now include emotional impact by evaluating the disease’s affect on Quality of Life (QoL). The QoL score indicates the patient’s interpretation of the impact of their disease on their quality of life. Because QoL is included in the assessment, a patient’s psoriasis may have been physically classified as only mild, but after consideration of the QoL score, it may be upgraded to severe.
Severity is very important when the healthcare provider is determining how to treat the disease. The patient may have a very small region of their skin, perhaps the back of the neck, affected by a psoriatic lesion. It may not itch or be painful and present with little scale. Physically, it may rank only as a mildly severe and indicate only moderate topical medication be prescribed. In this case, the patient may actually be very socially affected by the disease impacting their Quality-of-Life and desire more aggressive, faster therapy. Upgrading disease severity to "moderate" due to an impacted QoL score may warrant more aggressive and rapid therapy, such as targeted UV phototherapy or systemic drugs.
The patient should always make certain their healthcare provider is aware of their disease is impacted by their Quality of Life (QoL).