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According to the clinical and pathological features of psoriasis, it can be generally divided into six types of inflammation: vulgaris, arthritis, pustular, palmoplantar pustulosis, erythrodermic, and continuous acral dermatitis.

1. Psoriasis Vulgaris is the most common clinically, most of which are acutely ill and rapidly spread throughout the body. The initial damage is often red or brown-red papules, or maculopapular rash. It gradually expanded to become a brown-red plaque. The skin lesions are covered with dry scales. The boundaries are clear and adjacent damage can merge with each other.

The scales of this disease are silvery white, gradually thickened, and a translucent film can be seen when scraping off the scales. Some people call it a film phenomenon. Stripping of the film occurs as a point-like hemorrhage called Auspitz's sign. The membrane phenomenon is specific to the diagnosis of psoriasis by the Auspitz sign. Some patients have thick and hard scales that are clam-shelled and can affect the skin's expansion and contraction. The thick scaly on the articular surface is easily broken, causing the skin to cleft and feel pain.

Psoriasis vulgaris has more damage, some rashes are scaly droplets called punctate psoriasis; small scaly lesions are located in the hair follicle sebaceous gland opening, called follicular psoriasis; if the scales are clams It is called crustacean psoriasis; some lesions are irregularly map-like, called picoformosis; the most common clinical damage is disc-shaped or coin-like, called disc-shaped or coin-like psoriasis .

Psoriasis vulgaris can be spread throughout the body, but it is most common in the extremities of the extremities, especially the elbows, knees, symmetrical, and the appendix. Scalp damage is also common and can occur alone or in combination with systemic damage. The head damage is clearly defined and the hair is bundled but not hair loss. The nail can also be affected, and the surface of the nail is ��ejectoral�� or uneven. The surface of the nail is tarnished and can be thickened and grayish yellow. The deck is separated from the nail bed. The free edge can be broken or lifted. A small number of patients can be damaged in the lips, penis, glans, etc.

Psoriasis vulgaris is divided into three phases according to the performance of the lesion:

(1) During the period, the old skin lesions did not disappear and new skin lesions continued to appear. The skin lesions are infiltrated obviously, the inflammation is obvious, and the surrounding area may have redness and thick scales. In this period, such as acupuncture, stab wound, burn, surgery and other mechanical irritating skin, usually after 7 to 14 days, stimulate the surrounding skin to cause typical psoriasis damage, also known as artificial psoriasis (Psoriasis factitia) Is isomorphism, or Köebne phenomenon.

(2) quiescent period There is no significant change in skin lesions in the long-term, basically no new rash appears, inflammation is reduced, and the condition is stable.

(3) Degenerative period The inflammation of the damage basically subsides, and the rash shrinks or flattens. Leave pigment to reduce white spots or pigmentation spots. The disease is easy to recurrent. Some patients began to have obvious seasonality, with increased skin lesions in winter and remission or regression in summer. In the future, it will not heal for a long time. A small number of patients will not relapse after a long period of clinical recovery.

The disease has consciously varying degrees of itching. Recently, some patients with psoriasis have pathological changes of internal organs. Psoriasis patients may be associated with occlusive vasculitis, abnormal lungs, hepatic steatosis and focal necrosis. In keratoconjunctivitis, male patients may experience changes in the amount and quality of semen. Visceral damage in patients with psoriasis should be taken seriously in the treatment of psoriasis.

2. Arthritic psoriasis (Psoriasis arthropathica) is also known as psoriatic arthritis. In addition to the rash, this type of psoriasis can also have joint lesions, and joint symptoms are often reduced or aggravated with skin damage. However, patients usually have a rash first, and then there are joint symptoms. Any joint can be affected, including the large joints of the elbow and knee, or the small joint between the fingers. Spinal joints and ankle joints can also be violated. It can also have joint swelling and pain, limited mobility, and deformity, similar to the performance of rheumatoid arthritis. Bone can be destructively altered into a deformed deformity called destructive arthritis psoriasis. Severe arthritic psoriasis often has persistent high fever and accelerated erythrocyte sedimentation rate, but rheumatoid factor is often negative. The rash can also have changes in vesicular psoriasis. X-ray shows that some patients have the same joint changes as rheumatoid arthritis. The bone may have local decalcification, narrow joint space, and different degrees of joint erosion and soft tissue swelling. The course of the disease is chronic and often does not heal all year round.

3. Psoriasis pustulose

This type of psoriasis is rare, often without obvious inducement and acute onset, a large inflammatory erythema from the beginning, rapid on the basis of erythema, dense needles to miliary size yellowish yellow or yellowish white shallow sterile pustules, surface Often thin scaly, adjacent erythema can be fused to each other, in a ring or a shape. There are often more small pustules on the edge. In a short period of time, a small number of patients have rapidly reddened and swollen body, and there are countless sterile small pustules. The patient is often accompanied by general malaise, first with chills, then with high fever, with a relaxing heat type and a burning sensation on the skin. Joint swelling and pain. After a few days, the pustules dry and crusted. The condition can be naturally relieved, and the rash of psoriasis vulgaris appears. After a few days, it suddenly attacks, and the condition is repeatedly relieved and aggravated. The patient is often endangered by secondary infection, systemic failure or liver and kidney damage.

Pustular psoriasis can cause rash throughout the body. The most common is the flexion side, which increases rapidly in the future and extends to the whole body. Sometimes the oral mucosa and nails can also be affected. Often, there are often gully tongues, which are thick and turbid or broken, and there may be deposits or pustules under the deck.

4. Pasfulosis palmaris et plantaris Psoriasis pustulosis includes Pustular psoriasis of the palma and soles and Pustular bacterid.

(1) palmoplantar pustular psoriasis Some people think that it is a pustular psoriasis, which is more common in palmar, and the damage is common in the size of the palm and the sacral arch. Can also develop to the dorsal side of the finger (toe), symmetry erythema at the beginning, some small pustules appearing quickly, the surface is not uplifted, pustules are located in the epidermis, gradually expanding and merging, one or two weeks The inner dry sputum forms a suede, and small scales appear after the sputum falls off. But new pustules appeared, so repeated. The nail can be discolored or deformed. A turbid hypertrophy, ridges, conscious pain, other parts of the body may have atypical psoriasis lesions, or lesions of pustular psoriasis. Some patients have gully tongues.

(2) Pustular bacterial rash damage often occurs in the center of the palm or sole of the foot, gradually spread to the entire palm and sole, and can also spread to the side of the hand and foot. At the beginning, it is a blister and quickly becomes bacteria-free. Pustules, after a few days, the pustules become dry and become brown scaly. After the scales fall off, new pustules appear. This is repeated for several years. The skin can be red, thick, and scaly on the surface. Some patients have local itching and pain, and pustular bacteria culture is negative.

(3) Degenerative period The inflammation of the damage basically subsides, and the rash shrinks or flattens. Leave pigment to reduce white spots or pigmentation spots. The disease is easy to recurrent. Some patients began to have obvious seasonality, with increased skin lesions in winter and remission or regression in summer. In the future, it will not heal for a long time. A small number of patients will not relapse after a long period of clinical recovery.

The disease has consciously varying degrees of itching. Recently, some patients with psoriasis have pathological changes of internal organs. Patients with psoriasis may be accompanied by occlusive vasculitis, abnormal lungs, hepatic steatosis and focal necrosis. In keratoconjunctivitis, male patients may experience changes in the amount and quality of semen. Visceral damage in patients with psoriasis should be taken seriously in the treatment of psoriasis.

5. Erythrodermic psoriasis (also known as Erythrodema psoriaticum) This disease is often caused by improper treatment or other reasons to transform the original psoriasis vulgaris or pustular psoriasis For erythroderma. A common cause is the use of irritating topical drugs during the onset of psoriasis, or the rapid spread of some of the immunosuppressive drugs due to the sudden withdrawal of the drug. Common such as oral corticosteroids occur during the course of drug reduction.

At the beginning, the redness appeared in the original psoriatic lesions, and it quickly expanded into large pieces. Finally, more than 2/3 of the whole body skin was diffuse flushing and swelling, accompanied by a large number of squamous scales. In the meantime, there may be a sheet of normal "pitch island", and the scalp may have a large number of thick and dirty scales. The hands and feet can be peeled off in the form of "glove" style "socks". The nail is turbid, thickened or deformed. The disease may have fever, general malaise, superficial lymph node enlargement, and increased white blood cell count. Psoriasis damage occurs after erythroderma cures. The disease has a long course of disease and is prone to recurrence after healing.

6. Acrodermatitis continua This disease, also known as Dermatitis repens, is characterized by aseptic pustules. Therefore, it is considered that pustular psoriasis is The same disease. It is also considered to be a subtype of pustular psoriasis, but there are also different opinions. Considered to be an independent disease, this book describes the disease as a type of psoriasis.

The disease occurs in middle-aged people, most of which are caused by trauma. On the first side of a finger or toe, there is a small pustule of aseptic. After a few days, the pustules are dry and crusted, and the skin is peeled off. Left behind the bright red face, but soon there are new pustules appearing, the damage continues to expand, can invade the entire finger, toe, back of the hand and the back of the foot. This patient rarely becomes systemic or extends to a distant place. The disease mainly invades the extremities of the hands and feet, and occasionally can invade the oral mucosa, and the nails are more common. A turbidity is tarnished and deformed. In severe cases, nails may fall off, and sterile small pustules may appear repeatedly on the nail bed. The course of the disease is chronic and recurrent.