Inverse psoriasis in Adult
Alerts and Notices
SynopsisInverse psoriasis, also known as intertriginous or flexural psoriasis, is a form of psoriasis that presents in skin folds such as the inframammary areas, the axillae, and the inguinal folds. The plaques of inverse psoriasis are morphologically similar to those of classic plaque psoriasis in that they are erythematous and sharply demarcated; however, inverse psoriasis lacks the thick silver scale, and instead has a surface that is smooth, moist, and sometimes macerated. Mechanical friction of opposing skin surfaces within flexural zones is thought to result in koebnerization (isomorphic response), which perpetuates the condition.
Inverse psoriasis affects up to 30% of patients who have plaque psoriasis, and it most commonly presents in the inguinal folds. The external genitalia is involved in up to 80% of individuals with inverse psoriasis.
Lesions may be pruritic, irritated, or painful. Inverse psoriasis is also associated with a decreased quality of life and may adversely impact intimate relationships.
L40.8 – Other psoriasis
238600001 – Flexural psoriasis
Differential Diagnosis & Pitfalls
- Tinea corporis – Will have positive potassium hydroxide (KOH) examination.
- Intertrigo with secondary bacterial infection.
- Candidiasis – "Beefy" red erythema or satellite pustules prompt concern for candidiasis.
- Erythrasma – With "coral red" fluorescence by Wood's lamp examination.
- Seborrheic dermatitis – Can be difficult to exclude, even histologically.
- Hailey-Hailey disease (benign familial pemphigus) – An inherited acantholytic disorder with characteristic histologic findings. Clinically, plaques are more moist and fissuring is often more apparent.
- Darier disease (keratosis follicularis) – An inherited acantholytic disorder with characteristic histologic findings; unusual in the genital area.
- Subcorneal pustular dermatosis (Sneddon-Wilkinson disease) – Annular plaques with pustules along the border and often clear center.
- Impetigo herpetiformis – Occurs during pregnancy; pustules occur at the margins of the lesions.
- Genital lichen sclerosus – Atrophic, blue-white plaques.
Patient Information for Inverse psoriasis in Adult
OverviewPsoriasis is a chronic inflammatory condition that results in scaly red skin, called plaques. Inverse psoriasis is a type of psoriasis that develops in skin folds, such as the armpits, groin, genitals, and under the breasts. Unlike psoriasis, the plaques don't typically cause heavy scale because they are found in moist environments.
The lesions of inverse psoriasis are often mistaken for an allergic reaction or fungal infection.
Who’s At RiskYou are at risk if you have a family history of psoriasis.
The presence of a yeast infection in these areas can trigger a psoriasis outbreak.
Signs & SymptomsInverse psoriasis looks like pink or red inflammation and irritation in the folds of your skin. It may be itchy or may even cause a burning sensation.
Self-Care GuidelinesIf your psoriasis is moderate or severe, you may have a higher risk of chronic renal disease. Have your urine and blood tested at regularly scheduled check-ups.
When to Seek Medical CareCheck with your physician if you have skin inflammation that is not responding to antifungal treatment, or if you have a rash and a family history of psoriasis.
TreatmentsThere is no cure for psoriasis. Topical steroid creams or ointments are typically used to treat the symptoms.
If those don't prove effective or if the inflammation is widespread, your doctor might prescribe oral medication.
Inverse psoriasis in Adult