This document summarizes different types of psoriasis that can affect specific body sites. It discusses scalp psoriasis, follicular psoriasis, seborrheic psoriasis, flexural psoriasis, genital psoriasis, palmoplantar psoriasis, nail psoriasis, mucosal lesions, ocular lesions, and psoriatic arthritis. For each type, it provides details on characteristics, clinical presentation, and association with plaque psoriasis. Psoriatic arthritis is described as an inflammatory arthritis without rheumatoid factor that occurs in 5-10% of psoriasis patients.

1. Dr. Showket Ahmad Bhat
Source : 1. Rooks text book of dermatology 9th edition
2.Iadvl text book of dermatology
3. Bolognia dermatology 3rd edition

2. Psoriasis affecting specific sites
• Scalp psoriasis
• Follicular psoriasis
• Seborrhoeic psoriasis (sebopsoriasis)
• Flexural psoriasis (inverse psoriasis)
• Genital psoriasis
• Non‐ pustular palmoplantar psoriasis
• Nail psoriasis
• Mucosal lesions
• Ocular lesions
•Psoriatic arthritis

3. Scalp psoriasis
• Commonest areas affected by plaque psoriasis
• Often first affected.
• Diffusely involvement or multiple discrete plaques.
Plaques restricted to hair‐bearing areas•

4. Scalp psoriasis
Hair growth is normal
Not a frequent cause of alopecia

5. Follicular psoriasis
 Affect the hair follicles on trunk/limbs
 May occur as an isolated phenomenon or in association with
plaque psoriasis.

6. •Lesions smaller than typical
lesions of guttate psoriasis
• Either grouped or diffuse .
• Confused with PRP in
children

7. Seborrhoeic psoriasis (sebopsoriasis)
 Thin sharply demarcated erythematous with variable scale.
 Typical distribution of seborrhoeic dermatitis.

8. Flexural psoriasis (inverse psoriasis)
•Inguinal creases, axillae, submammary folds, gluteal
cleft, umbilicus and other body folds .
•More common in older adults,associated with obesity.
•Flexural involvement seen in
individuals with plaque psoriasis
elsewhere on the skin.

9. • Failure to respond to
antibacterial /antifungal
arouse
suspicion.
•Flexural plaques are thin,
scaling is greatly reduced or
absent.

10. Genital psoriasis
•Genital skin type of flexural skin, affects flexural and
genital sites.
•The genital skin is involved in individuals with inverse
psoriasis, less frequently in plaque psoriasis and may be
only manifestation of psoriasis.

11. •Effects sexual function.
•Scrotum and penile shaft affected & glans is most
frequently affected part.

12. Genital psoriasis

13. Non‐ pustular palmoplantar psoriasis
•Typical scaly patches on which a fine silvery scale can be
evoked by scratching.
•Less well‐defined plaques resemble lichen simplex or
hyperkeratotic eczema.
• Mixed forms occasionally occur .

14. Non‐pustular palmoplantar psoriasis

15. Nail psoriasis
• Nail dystrophy seen in association with all types of
psoriasis or occasionally isolated.
•Minor lesions (e.g.pitting) difficult to define clinically,
have been detected by ultrasonography .

16. • Up to 73% associated with extensive psoriasis, longer
disease duration, family history of psoriasis and the
presence of psoriatic arthritis.
• Pitting is the most frequent change seen in fingernails.

17. Nail psoriasis

18. Mucosal lesions
•True mucosal involvement appears to be rare.
•Geographic tongue (benign migratory glossitis) and
fissured tongue more frequent.

19. •The association of both
psoriasis and geographic
tongue with HLA‐C:06:02
provides further evidence that
the two disorders are related,
but whether geographic
tongue is an oral manifestation
of psoriasis per se remains to be
established.

20. Ocular lesions
•Affect directly or by immunological phenomena.
• Direct involvement may cause blepharitis,most
frequent ocular complications.

21. •Chronic non‐specific conjunctivitis and xerosis may
be seen. Keratitis is rare.
•Uveitis is immunologically mediated , associated with
more extensive psoriasis/psoriatic arthritis .

22. Psoriatic Arthritis
• Inflammatory arthritis with negative RF.
• 5% to 10% of patients ,onset concurrent with the skin
disease in 10% of cases , rarely precede it.

23. •Five types of psoriatic arthritis:
Classic Type
Psoriatic Spondylitis
Oligoarticular Arthritis
Arthritis Mutilans
Rheumatoid Type

24. Psoriatic Arthritis

25. THANKS