Psoriasis is a serious skin disorder that affects about 7.5 million people in the United States. Plaque psoriasis—characterized by reddish plaques on the skin—is the most common type of this condition, but it's not the only type. In fact, there are many lesser-known types of psoriasis, including inverse psoriasis. Between 3% and 7% of people with psoriasis develop inverse psoriasis. Here are three things you need to know about this condition.
What are the signs of inverse psoriasis?
Unlike other types of psoriasis, inverse psoriasis affects the flexural surfaces of your skin. Flexural surfaces are skin surfaces that touch when you move your joints. For example, your armpits, the backs of your knees, the insides of your elbows, and your inner thighs are flexural surfaces. Any other skin folds can also be affected.
If you develop inverse psoriasis, these flexural surfaces will develop smooth, swollen lesions. While other types of psoriasis cause scaly lesions, the lesions of inverse psoriasis are smooth. This is because the flexural surfaces and skin folds tend to be moist, and this moisture prevents the lesions from becoming scaly.
Why does inverse psoriasis develop?
Researchers still don't fully understand why psoriasis develops. The currently accepted theory is that psoriasis is an immune system problem. Your white blood cells attack your healthy skin cells, and this attack stimulates production of more skin cells. Since skin cells are being produced more quickly than they should be, lesions appear on the skin. There are many factors that are believed to trigger this process.
Inverse psoriasis may be triggered by a buildup of yeast within your skin folds. Yeast, also called candida, is a type of fungus that can infect your skin. Yeast likes to live in warm, moist areas, so it can thrive in skin folds.
Injuries to your skin are another possible trigger. The flexural surfaces are subjected to friction when you move, and this friction can damage your skin. Cuts, scrapes and sunburns can also damage your skin and trigger inverse psoriasis.
Other factors that have been linked to psoriasis are stress, cold weather, smoking and drinking a lot of alcohol.
How is inverse psoriasis managed?
Psoriasis can't be cured, so treatment will focus on controlling your symptoms. Inverse psoriasis is harder to treat than other types of psoriasis. It doesn't respond as well to traditional treatments, and not treatments are appropriate for the delicate skin that covers the flexural surfaces. For example, other types of psoriasis can be treated with exposure to ultraviolet light, but your flexural surfaces may be too easily burned for this method.
Topical treatments are the first line of treatment for inverse psoriasis. Corticosteroid creams can be used for short-term relief of the symptoms, but due to the risk of side effects, they aren't suitable for long-term use.
For long-term control of your symptoms, you may be prescribed a calcipotriene cream. Calcipotriene is a vitamin D3 derivative that can slow down skin cell production. This cream can take up to eight weeks to start working, and if you stop using the cream, your symptoms will return. This is because calcipotriene isn't a cure for psoriasis; it just keeps it under control.
Adalimumab is a newer medication that has shown promise in the treatment of stubborn inverse psoriasis. This medication is a TNF-a inhibitor, which means that it helps to control your inflammatory response. One study found that when the drug was given by subcutaneously once every two weeks for a period of 90 days, the lesions of inverse psoriasis cleared up and did not return. Your dermatologist may try this therapy if more established therapies don't work.
If you're worried that you have inverse psoriasis, make an appointment with a dermatologist to talk about your concerns. Visit websites like http://ADCderm.com for more information.