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Course of Psoriatic Arthritis. Although patients with psoriatic arthritis tend to have mild skin manifestations, the disease is systemic; that is, it affects the body as a whole. PsA, therefore, is more serious than the more common plaque psoriasis.
Infrequently, the course of PsA has been associated with a syndrome known by the acronym SAPHO, whose letters form the symptoms:
- Synovitis (inflammation in the joints).
- Acne.
- Pustule eruptions.
- Hyperostosis (abnormal bony growths).
- Osteolysis (bone destruction).
Prevalence of Psoriatic Arthritis. Estimates on its prevalence among those with psoriasis range from 2% to as high as 42%. AIDS patients and those with severe psoriasis are at higher risk for developing PsA.
Less Common Forms of Psoriasis
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Psoriasis Form
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Description of Skin Patches
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Guttate Psoriasis
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The patches are teardrop-shaped and erupt suddenly, usually over the trunk and often on the arms, legs, or scalp.
The teardrop patches often resolve on their own without treatment.
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Guttate psoriasis can occur as the initial outbreak of psoriasis, often in children and young adults one to three weeks after a viral or bacterial (usually streptococcal) respiratory or throat infection. A family history of psoriasis and stressful life events are also highly linked with the onset of guttate psoriasis.
Guttate psoriasis can also develop in patients who have already had other forms of psoriasis most likely in people treated with widely-applied topical corticosteroid dressings.
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Inverse Psoriasis
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Patches usually appear as smooth inflamed patches without a scaly surface.
They occur in the folds of the skin, such as under the armpits or breast or in the groin.
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Inverse psoriasis may be especially resistant to treatment.
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Seborrheic Psoriasis
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Patches appear as red scaly areas on the scalp, behind the ears, above the shoulder blades, in the armpits or groin, or in the center of the face.
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