Plaque psoriasis is the most common type of psoriasis. Plaques are pink/red, raised, thick, inflamed skin patches covered by silvery-white scales. They typically have well-defined edges and may itch.

Plaques can occur anywhere on the body but most commonly develop on the scalp, elbow, knees, and lower back.There is no known cure, but long-lasting remissions are possible.

Psoriasis vs. Plaque Psoriasis

Psoriasis is a chronic condition that occurs when the immune system mistakes healthy skin cells for foreign invaders, causing those cells to multiply too quickly. There are several types of psoriasis, and plaque psoriasis is the most common. Of the people who have psoriasis, 80–90% have plaque psoriasis.

Symptoms

The signs and symptoms of plaque psoriasis will vary from person to person based on the severity of the condition. Many people will find that they have the following symptoms:

• Plaques that are thick, pink/red, and covered with silvery white scales
• Plaques that show up symmetrically on the body (e.g., both elbows or both knees)
• Itching
• Burning or pain
• Pinpoint bleeding if a scale skin is removed (Auspitz sign)
• Fissures along plaques on the palms, soles of the feet, or on thick plaques

Individual plaques can measure from 1 centimeter up to several centimeters in diameter, and come together to form larger patches.

What Causes Plaque Psoriasis?

Psoriasis is an autoimmune condition. Experts don't know the exact cause of psoriasis, but both the immune system and genetics are major contributors to development, along with other variables.

Psoriasis can be hereditary. Specific genes make it more likely for someone to develop the condition. However, some people who get psoriasis do not have those genes. In other cases, people with psoriasis genes may never develop the condition.

Plaque Psoriasis Triggers

A psoriasis trigger is something that causes psoriasis to worsen. These periods of worsening psoriasis are called flare-ups. Common psoriasis triggers include:

• Stress
• Skin injury
• Smoking
• Heavy alcohol consumption
• Infection
• Cold, dry weather
• Shaving
• Medications

Not everyone with psoriasis will have the same triggers. People must find their triggers and work to avoid them to prevent flare-ups.

How Diet Impacts Plaque Psoriasis

Plaque psoriasis is an autoimmune condition that causes excess inflammation within the body. There is no specific psoriasis diet, but some studies have shown that diet can improve psoriasis in some people.

Celiac disease tends to be more common in people with psoriasis. People with psoriasis who are also sensitive to gluten may find symptom relief with a gluten-free diet.

A 2018 review from the Journal of the American Academy of Dermatology recommends that those who carry excess weight or people with obesity should seek weight reduction by consuming fewer calories. The journal also states that there is minimal evidence to promote any specific dietary pattern or specific foods or nutrients to reduce psoriasis.

Diagnosis and Severity

Plaque psoriasis is diagnosed based on clinical appearance, history, and, if necessary, a skin biopsy.

A healthcare provider will examine the skin lesions and, in many cases, determine if the patient has plaque psoriasis. If uncertain, the healthcare provider can take a small skin sample and send it to a lab for a firm diagnosis.

Psoriasis Area Severity Index (PASI)

The Psoriasis Area Severity Index (PASI) is a scale for assessing and grading the severity of psoriasis and the response to treatment.

The scale uses a score from 0–72. Scores indicate the following severity levels:

• None to mild: 0–4
• Moderate: 5–10
• Severe: greater than 10

The PASI is calculated based on the percentage of body area affected, redness, scaling, and lesion thickness.

The PASI does have its limitations. It does not consider how psoriasis affects a person's quality of life.

Psoriasis Complications

Those with psoriasis are at greater risk of developing other conditions, including:

• Temporary skin discoloration
• Obesity
• Type 2 diabetes
• High blood pressure
• Another autoimmune disease (e.g., celiac disease, sclerosis, Crohn's disease)

Treatment

Plaque psoriasis treatment can require both over-the-counter therapies and prescriptions. Several treatment options include:

• Over-the-counter: Creams, lotions, and moisturizers, which treat dry skin and itching
• Prescription topical creams: Corticosteroid (steroid) creams, which treat plaque psoriasis
• Non-biologics: Suppress the immune system to reduce symptoms
• Biologics: Suppress the immune system and are typically given as a shot or intravenously
• Phototherapy: UVA/UVB or laser light therapy, which takes place in a healthcare provider's office

Preparing for a Psoriasis Appointment

When visiting a healthcare provider, be prepared to give a complete health history and any family history of psoriasis. Provide a list of any medications, supplements, and vitamins you are taking. If you suspect any specific triggers be sure to mention those as well.

Self-Care and Prevention

Psoriasis self-care will look different for each person. This may include managing triggers like stress with relaxation or meditation.

Though psoriasis can't be prevented, reducing exposure to triggers, taking any prescribed medications, and following a healthy diet can reduce episodes.

Does Plaque Psoriasis Ever Go Away?

There is no known cure for psoriasis.However, people with plaque psoriasis go through periods when the rash improves or goes away.

Treatment can be very successful at dramatically minimizing or eliminating symptoms. Work with a healthcare provider to find the right treatment plan to obtain the best results.

What Happens if Psoriasis Is Left Untreated?

The systemic inflammation that causes psoriasis can affect multiple organs besides the skin. If left untreated, the inflammation can gradually spread and trigger changes in the nails, joints, eyes, brain, kidneys, heart, pancreas, and blood vessels.

Early treatment of psoriasis can help to control inflammation and prevent or delay further medical complications like:

• Psoriatic arthritis
• Eye problems
• Mood disorders
• Cardiovascular disease
• Cancer

Summary

Plaque psoriasis is one type of psoriasis. It is an autoimmune condition that causes raised, red skin lesions covered with white or silver dry skin scales. There is no cure but, with treatment and lifestyle management, long periods of improvement or remission are achievable for many people.

Treatment varies from person to person but typically involves a prescription medication or topical cream. Avoiding things that cause psoriasis to worsen and following a healthcare provider's treatment plan can help relieve symptoms.