The first signs of psoriasis

Psoriasis on the elbows

Many people do not know how psoriasis starts, because the disease is not among the most common. However, the incidence of psoriasis increases each year.

With timely access to a doctor, you can act quickly, because it is always easier to deal with the disease at an early stage.

Early onset or debut of psoriasis

The initial stage of the disease is not specific. The rash is a traditional symptom. It has several characteristics that will help to distinguish the first symptoms of psoriasis from other skin diseases:

  • Small size of skin rashes. The appearance of the disease is accompanied by the formation of small pathological elements. They rarely exceed 3 mm in size.
  • Round shape. With the development of psoriasis, the plaques maintain the correct shape.
  • Pink or red color of the rash.
  • Itching. The appearance of psoriasis is not always accompanied by this symptom. It manifests itself in only half of all clinical cases. Whether itchy psoriasis in the early stage depends more on the individual characteristics of the organism.
  • Peeling. It occurs relatively rarely in the early stages of the disease. It often accompanies the progression phase of psoriasis.

Small plates are covered with silver scales. Hence the second name of the disease - "scaly lichen". The appearance of pathological elements is often associated with some type of strong experience or infection of the skin.

The classic triad of symptoms

Woman's hand with psoriatic plaques

In addition to the indicated signs of psoriasis, its initial stage, like others, is accompanied by an obligatory triad of symptoms. They distinguish psoriasis from several other dermatoses. The following manifestations remain characteristic of the scaly lichen:

  • Stearin staining phenomenon. After the scales are removed, a kind of stain appears under them, reminiscent of paraffin or stearin.
  • The "terminal film" phenomenon. With more scraping of the contents of the plate, a shiny surface appears. It resembles polyethylene. This is the last element to be removed from the skin.
  • Blood dew phenomenon. With the continuation of the film's scaleless hairstyle, several drops of blood appear. They increase, fuse due to damage to microvessels located in the affected area. Capillary bleeding occurs, which soon ceases.

Thanks to these symptoms, doctors know how to recognize psoriasis at an early stage. The main thing to remember is that the scraping is done with a blunt scalpel or microscope slide. You should not do this with the nail.

Provocation factors

Stress is a trigger for psoriasis

More often, the disease develops smoothly. The first signs appear. They cannot cause any discomfort to the patient.

In this case, it is important to see a doctor as soon as possible to interrupt the process.

The onset of psoriasis, manifested by typical plaques, is accompanied by a positive Koebner symptom. It consists of the formation of new skin elements during the mechanical irritation of healthy areas of the skin. In addition, this phenomenon manifests itself in the form of the development of new elements of the rash at the site of skin lesions - scratches, bruises.

Factors that cause psoriasis in the body:

  • genetic predisposition;
  • chronic stress;
  • taking medication;
  • transferred purulent skin diseases (pyoderma, furunculosis) of the skin;
  • bad habits;
  • endocrine pathology;
  • Unfavorable environmental conditions and unhealthy diet.

When the first manifestations of psoriasis occur, you should immediately seek help from a dermatologist. Otherwise, the disease will only progress.

Initial symptoms in different places

Traditionally, the disease occurs first on the extensor surfaces of the knee and elbow joints. These are the preferred places for acne. First, small pathological areas are formed that rise slightly above the level of the skin. They grow over time. Psoriasis appears more often after severe stress or an infectious disease.

Psoriasis and its initial stage, which is located on the extensor surfaces of the joints, are usually accompanied by redness of pathologically altered areas of the skin. This is due to the constant friction of the plates against clothing.

Manifestation of psoriasis on the extensor surfaces of the elbow joints

Face and neck

The initial stage of psoriasis, whose symptoms develop on the face and neck, has several characteristics:

  • Limited pathological elements. They are small, rarely merging.
  • Typical location around the eyes, in the earlobes, in the nasolabial folds, in the eyebrows.
  • Possibility of complete absence of itching.

The rash resembles small papules with all the characteristics of psoriasis (silver scales and a triad of phenomena).

Hairy part of the head

Typical early plaques usually appear on the scalp, along the hairline. A specific reddish border is formed, covered with scales. It is called a "psoriatic crown".

An additional feature of scalp psoriasis is the dysfunction of the sebaceous glands. Scalp psoriasis progresses as seborrhea. Dandruff is present and does not respond well to conventional treatments.

Scalp psoriasis

Body and back

A characteristic of cutaneous psoriasis on the back and body is a rare manifestation of symptoms in this area at the normal rate of development of the disease. The appearance of new pathological elements in the abdomen or under the shoulder blades usually indicates the generalization of the process.

The first stage of acne often develops elsewhere. Purple teardrop-shaped elements appear on the back and body.

Breasts and nipples

The first signs of psoriasis progress as normal plaques in the areola. They are accompanied by itching, flaking and covered with scales. An additional symptom is the occurrence of cracks and injuries.

This usually happens in nursing mothers. A secondary infection joins the progression of symptoms (pain, swelling, redness, increased local body temperature).
This situation is fraught with acute mastitis, so an urgent consultation with a surgeon is required.

Palms and soles

The initial stage of psoriasis is accompanied by thickening of the epidermis in the case of localization on the palms and soles of the feet. The skin is hard. Subject easily to physical injuries. Bacterial and fungal infections are common.


The symptoms of nail psoriasis appear as onychodystrophy. Damage to the nail plate occurs. Typical early signs of the disease:

  • thickening or thinning of the nail plate;
  • the appearance of transverse or longitudinal lines on its surface;
  • change in nail color and consistency. It can fall apart. The worst case scenario is onycholysis with complete plaque shedding.

The symptoms of the onset of psoriatic rashes are varied. It is important to know how to recognize them in time and seek help from a dermatologist. He's going to get a treatment. An early medical consultation usually leads to an early stabilization of the condition.

Psoriasis in children

Psoriasis in child

Many people are interested in how psoriasis manifests in children. It resembles the clinical picture of adults, but has several characteristics:

  • Plaques are more likely to occur in atypical locations. They can be folds of the skin, mucous membrane of the mouth, genitals.
  • Constant itching. In children, rashes are accompanied by severe discomfort, which often interferes with sleep.
  • Pronounced red color and flaking of the plates.

If typical papules appear on your child's skin, you should see a doctor immediately. Early psoriasis in babies can easily be mistaken for allergies and atopic dermatitis. It is strictly forbidden to start any treatment without consulting a doctor.

Psoriatic arthritis

A separate form of the disease remains psoriatic arthritis or arthropathy. It is accompanied by the involvement of connective tissue and joints in the pathological process. In the early stages of the disease, this is extremely rare, but exceptions sometimes occur.

Typical early signs of arthritis:

  • pain and discomfort in the joints, early and early pain;
  • redness and swelling of the soft tissues;
  • limit the range of motion;
  • function violation;
  • stiffness.
Psoriatic arthritis of the knee

In the early stages, psoriatic arthritis needs to be differentiated from rheumatoid, reactive and gouty variants of joint damage. For this, auxiliary diagnostic procedures are performed - ultrasound, X-ray, magnetic resonance, sometimes even puncture.

Severity of the disease

The initial stage of psoriasis is usually mild. The symptoms are minimal. A person may not complain, only his eyes are attracted to incomprehensible elements of the skin and psychological discomfort arises.

In rare exceptions, the pathology develops quickly, with a pronounced clinical picture. Depending on the severity, the following degrees of skin lesions are distinguished:

  • Easy. Less than 3% of body coverage is involved in the pathological process.
  • Medium. 3-10% of the skin is affected.
  • Heavy. The plaques appear simultaneously in more than 10% of the skin area. The most serious form is psoriatic erythroderma, in which a large area of the skin is affected.

Depending on the severity of the disease, the approach to therapy will be different.

Peculiarities of treatment

The initial stage of psoriasis, which is often overlooked by patients, is the best time to start therapy. As soon as the first symptoms appear, you should immediately consult a doctor.


Rapid diagnosis and therapy selection will help to stop the development of psoriasis, even in the early rash phase.

It will not be possible to completely eliminate the pathology. Psoriasis is one of the non-fatal, but incurable, diseases. However, if you take control from the start, the symptoms progress slowly and do not change the person's lifestyle. With successful treatment, long-term persistent remission with complete cleansing of the skin is possible.

In the early stages, psoriasis is best treated with topical medications. They minimize side effects and complications and are easy to use.

The following groups of drugs are used most frequently in medical practice:

  • Hormonal ointments. The active components are glucocorticoids. They have a pronounced anti-inflammatory effect and reduce the activity of the pathological process.
  • Retinoids for external use. Influence the maturation, division and rejection of keratinocytes. Improves the condition of the skin.
  • Medicines based on vitamin D. They increase the effectiveness of the medications in the previous group. Can be used independently. They stabilize the skin's metabolism, prevent flaking and the formation of new pathological elements.
  • Auxiliary polishes. They are created based on salicylic acid, zinc, sulfur. They improve the condition of the skin nonspecifically - they moisturize or dry (depending on the need), clean the skin of the scales.

In the early stages, popular recipes are acceptable. They are ointments based on tar, naphthalene, decoctions and lotions of medicinal herbs or baths with sea salt.

Before treating psoriasis, it is essential to pay attention to the fact that, at the beginning of the disease, adherence to the norms of a healthy lifestyle, normalization of body weight and the mandatory rejection of bad habits certainly help to eliminatethe skin rashes. Sometimes, just meeting these simple and reasonable requirements leads to the fact that the disease recedes and never returns.