Inverse Psoriasis

Psoriasis is an immune-mediated disease where skin cells multiply too quickly. This rapid life cycle of skin cells results in symptoms affecting the skin, such as scaly and silvery lesions, red patches, and sores filled with pus. Symptoms of psoriasis depend on the type of psoriasis. Inverse psoriasis is a type of psoriasis occurring in the folds of the skin. This immune-mediated inflammatory skin disease causes itchy, scaly patches and plaques to appear, and in skin folds, the plaques may appear shiny.

Early inverse psoriasis treatment is optimal for identifying and pursuing an effective treatment plan that addresses your needs. Each dermatologist in Gainesville, FL, with Gainesville Dermatology & Skin Surgery, offers the highest level of patient care in our state-of-the-art facility. Contact our office today to schedule a dermatologist appointment and to learn more about our available skincare and treatments for various skin conditions.

What Is Inverse Psoriasis?

Inverse psoriasis, also referred to as flexural psoriasis or intertriginous psoriasis, is a form of psoriasis affecting skin areas that rub together like skin folds, such as the groin, armpits, belly button, and skin below the breasts. Inverse psoriasis causes the skin cells to reproduce quicker than the skin can manage. It appears as shiny, smooth, discolored rashes that may be brown, red, or purple. The rashes or plaques may feel damp to the touch. Inverse psoriasis is often called an autoimmune disease, yet the antibody that causes the condition has not yet been identified.

As such, it is categorized as an immune-mediated disease, meaning the exact cause is unknown, but experts believe the cause is the immune system's response. Psoriasis is characterized by the production of thick, discolored patches on the skin covered with white or silvery scales or plaques. In contrast, inverse psoriasis does not feature thick, scaly patches characteristic of other types. This is likely because inverse psoriasis is present in moist body areas. An inverse psoriasis rash also appears shinier than other psoriasis rashes.

Inverse Psoriasis Vs. Intertrigo

Inverse psoriasis and intertrigo are inflammatory skin disease rashes in skin folds. Yet, inverse psoriasis and intertrigo have different causes and treatment options. Intertrigo is caused by skin rubbing against the skin. Moisture becomes trapped in the surfaces of the skin, causing the skin to come together in the skin folds. The moisture increases the level of friction of the skin-to-skin contact, resulting in skin damage and inflammation. Keeping the affected skin clean, dry, and cool can help alleviate the symptoms associated with intertrigo.

In contrast, inverse psoriasis is an immune-mediated disease, meaning the body’s immune system attacks parts of the skin instead of protecting the body from bacteria, viruses, and other foreign invaders. Treatments for inverse psoriasis can help reduce the symptoms of the disease or make them dissipate altogether. However, inverse psoriasis is typically a chronic condition, meaning flare-ups can occur throughout one’s lifetime.

What Does Inverse Psoriasis Look Like?

Inverse psoriasis is known by its presentation as a red, shiny, smooth skin rash. On individuals with darker skin, the rash may appear dark purple, brown, or darker than the surrounding skin. Unlike other forms of psoriasis that produce scales, pustular spots, and crusting skin, inverse psoriasis rashes are not raised nor dry. In fact, inflamed skin patches from inverse psoriasis can feel moist to the touch.

Individuals with this condition may experience irritation, itching, or both in the affected areas. Additionally, individuals with this psoriasis are at risk of developing yeast infections due to the high degree of moisture. The red lesions may cover large areas within the skin folds. Contact our dermatology clinic for more information!

What Causes Inverse Psoriasis?

Inverse psoriasis is a disease of the immune system. In people with flexural psoriasis, their immune system overreacts and causes inflammation, which results in the extremely rapid growth of new skin cells. Skin cells without this condition typically grow every 28–30 days. However, new cells grow and move to the surface of their skin every 3–4 days in people with this form of psoriasis.

The buildup of new skin cells results in a shiny rash. Additionally, inverse psoriasis often runs in families, so genetic predisposition may exist. Parents with inverse psoriasis may pass the condition on to their children. If you are overweight and have psoriasis, you have a higher risk of developing inverse psoriasis, as the extra body weight produces excess skin and deeper skin folds.

What Triggers Inverse Psoriasis?

Inverse psoriasis flare-ups differ from person to person. There are no known causes of these flare-ups. Common inverse psoriasis triggers may include skin injuries, such as cuts, scrapes, surgery, emotional stress, streptococcal infections, or other infections dealing with the immune system and certain prescription medications like beta-blockers and lithium. Inverse psoriasis is not contagious. You cannot spread the disease to another person through skin-to-skin contact. Individuals who are overweight have a higher risk of developing inverse psoriasis than those who are not overweight. Other potential triggers include smoking, drinking alcohol, and friction within deep skin folds.

What Are The Symptoms Of Inverse Psoriasis?

General inverse psoriasis symptoms include a shiny, smooth, discolored rash that may be brown, pink, or purple, cracks or fissures in the skin, creases, itchiness, and moist patches of skin. In patients with inverse psoriasis with an infection, symptoms may include bumps in the affected area or areas of skin that contain pus, a foul inverse psoriasis smell, small cuts or tiny cracks in the skin, swelling, and tenderness. Because the areas of skin affected by inverse psoriasis rub together regularly, the skin cells naturally slough off before the patches become scaly.

Pain may accompany inverse psoriasis lesions, especially when there is excessive friction between the folds. The delicate nature of the tissue located in skin folds only increases their risk of injury, which commonly causes fissures and bleeding in the affected skin. Increased warmth and moisture within skin folds also make them extremely vulnerable to bacterial and fungal infections. Inverse psoriasis can develop on its own or co-occur with other forms of psoriasis, which may result in additional symptoms.

Inverse Psoriasis Location

Inverse psoriasis develops where skin touches the skin, such as the armpits. This differentiates it from plaque psoriasis, often affecting the kneecap and other extensor surfaces. The skin folds most commonly affected by inverse psoriasis include the following. In people who have obesity, lesions can develop within rolls of their abdominal skin, under double chins, between the thighs, and alongside the overhanging skin of the upper arms.

Around the genitals
In creases of the groin
Between the buttocks
Under the breasts
Within the navel
Behind the ears

How Is Inverse Psoriasis Diagnosed?

Your Gainesville dermatologist will examine the affected areas of your skin and look for common signs that indicate inverse psoriasis. They will also ask you about your symptoms, family history, and whether you have recently started or stopped taking medications or using a product before your flare-up. To diagnose cases of inverse psoriasis, our dermatologists may perform several tests to rule out other conditions that may cause the rash. This is known as a differential diagnosis.

These diagnostic tests may include an allergy test, skin biopsy, and blood tests that check for causes of the rash unrelated to inverse psoriasis. If you have inverse psoriasis, you may be at a higher risk of developing certain conditions, such as diabetes, heart attack, high cholesterol, obesity, and stroke. For more information, contact Gainesville Dermatology & Skin Surgery.

Inverse Psoriasis Treatment

There is no known cure for inverse psoriasis. Individuals with inverse psoriasis may experience flare-ups and times when their rash goes away or is in remission. Intertriginous psoriasis treatment from your dermatologist can relieve symptoms associated with the condition. Unfortunately, there is no way to prevent inverse psoriasis. However, treatments from our dermatologists can help reduce your symptoms. Your dermatologist may prescribe inverse psoriasis treatments to help alleviate your symptoms.

Calcipotriene skin ointment. Calcipotriene is a type of vitamin D that helps reduce the appearance of discoloration on the skin.
Topical corticosteroids. Prescription corticosteroid creams or ointments can help reduce inflammation associated with inverse psoriasis.
Injectable medicines. Your provider may inject medicine into your vein or under your skin with a hypodermic needle.
Oral medications. Certain oral medicines, such as pills or capsules, are taken by mouth and are used to treat severe cases of inverse psoriasis.
Phototherapy. Phototherapy or light therapy uses ultraviolet (UV) light, typically ultraviolet B (UVB) light, to help certain skin disorders, including inverse psoriasis.
Pimecrolimus skin cream. Pimecrolimus skin cream or tacrolimus ointment is usually used to treat eczema, but they may help treat inverse psoriasis, too.

Inverse Psoriasis Home Remedies

Certain home remedies can help individuals with inverse psoriasis manage their symptoms in combination with treatment from their dermatologist. While home remedies are safe for most individuals, check with your provider before trying home remedies, as you may be at risk of developing an allergic reaction.

Take over-the-counter antihistamines to help reduce itchiness
Bathe or shower in lukewarm water
Shower or bathe for 15 minutes or less
Use mild soaps and skincare products that are free of fragrances, dyes, and alcohol
Moisturize your skin using a dermatologist-approved product
Moisturize your skin several times daily, including after you bathe or shower.
Wear loose clothing and undergarments that allow the affected skin to breathe
Apply power to your affected skin to help absorb moisture