7 Common Places Psoriasis Can Develop on Your Body

From health.com

AT A GLANCE

• Psoriasis can affect any part of your skin. Sometimes it can affect multiple parts of your body.
• Your elbows, knees, trunk, and scalp are among the most common areas where psoriasis develops. It can also affect your palms, soles of the feet, nails, face, and genitals.
• Certain areas of the body may be harder to treat with traditional psoriasis creams or gels, and you may need to explore other treatment options.

Psoriasis can affect almost any part of your skin. Sometimes the skin condition can affect multiple areas of the body at once or different areas over time. Could the changes on your skin be a new patch of psoriasis? Here are some places on the body where psoriasis is particularly common. (And keep in mind, the location of your psoriasis could dictate the kind of treatment that’s best for you.)

1. Elbows and Knees

Your elbows and knees are common spots for the most common kind of psoriasis, called plaque psoriasis. It leads to itchy, painful, red patches of skin that are covered by silvery-white scales. 

Usually, these patches are found in a symmetrical pattern on the outside of your knee or the outside of the elbow, called the extensor surfaces. These areas may be particularly prone to breakouts because they are exposed to more friction than other parts of your skin.

Treatment: Topical (applied directly to the skin) treatments typically work well. But based on how severe the psoriasis is, you may need different types of medication, such as oral medication, biologics, or light therapy.

2. Trunk, Arms, and Legs

People can commonly have psoriasis in areas that cover a large percentage of their skin, such as the chest, abdomen, back, arms, and legs. Most often, this is the plaque kind of psoriasis. Some people might get a kind of psoriasis called guttate psoriasis in these regions, which causes small red dots.

Treatment: Prescription creams, like vitamin D creams, corticosteroid creams, or coal tar creams, are not as effective when psoriasis affects large portions of the body. Instead, you might need treatment that you take orally or via an injection.

3. Scalp 

Around half of people with psoriasis have symptoms affecting their scalp, such as silvery-white scaly patches, itching, and pain. The scalp is one of the first places people typically experience psoriasis symptoms. However, it might not be diagnosed at first, as it’s often first mistaken for severe dandruff (seborrheic dermatitis). It is especially associated with psoriatic arthritis.

Treatment: Some people see improvements with therapeutic creams that are applied directly. However, some people find it difficult to apply the creams to their scalp, and some don’t like the way these creams look cosmetically. So, scalp psoriasis is sometimes undertreated.

4. Face

Although not as common as in other regions, up to half of people with psoriasis may have some psoriasis symptoms on their face at some point. Psoriasis can appear on any part of your face. 

Psoriasis on the face may interfere with the typical things you need to do with the muscles of your face, like chew. People with facial psoriasis also tend to have more severe psoriasis symptoms overall.

Treatment: Facial psoriasis may be more difficult to treat than psoriasis in some other parts of the body because the skin there is quite delicate. For example, it’s important not to overuse strong corticosteroid creams on your face.

5. Nails

About 40-50% of people with psoriasis have symptoms that affect their nails. It is especially associated with psoriatic arthritis.

Nail involvement in psoriasis can cause various nail changes, such as:

• Rough nails
• Brittle nails that are prone to crumbling
• Nail pitting (small dents)
• White discoloration
• Red spots on your nails
• Separation of the nail from the underlying nail bed 

Treatment: Topical medications are often not very effective at treating nail psoriasis. Injections into the nail or oral therapies may work better.

6. Palms of the Hand and Soles of the Feet

Psoriasis affects the palms of the hands or the soles of the feet in around 15% of people with the skin condition. Another word for this is palmoplantar psoriasis. It can look like plaque psoriasis, but some people get bumpy pustules.

Psoriasis that affects these parts of the body can particularly interfere with your day-to-day activities and quality of life.

Treatment: You can try some of the same topical treatments that are used for psoriasis in other places. However, certain medicated creams might not be as effective where the skin is thick, like calluses on your feet.

7. Skin Folds

Sometimes psoriasis affects areas where your skin folds together, like in your armpit, beneath your breasts, around your anus, around your belly button, or around your ears. It can also affect the external genitalia, especially in males. This type of psoriasis is called inverse psoriasis or intertriginous psoriasis.

Experts used to think that this kind of psoriasis was rare, but it’s now believed to affect about 20-30% of people with psoriasis. Usually, the areas are moist and shiny, not with the whitish scales seen in plaque psoriasis. The areas are usually clearly outlined and symmetric on both sides, with intense itchiness.

Sometimes it’s hard for healthcare providers to distinguish psoriasis in these areas from other kinds of skin conditions that can cause irritation in skin folds.

Psoriasis that affects the genitals is often especially bothersome. It can lead to embarrassment and shame, negatively impacting personal relationships. Instead of smooth and red, psoriasis here is sometimes more like the itchy white flakes of plaque psoriasis.

Treatment: Because the skin folds and sensitive areas have thinner skin, the strongest steroids are not best. Instead, non-steroidal topical medications may be safer for these areas. Your provider may also recommend that you use a powder to keep any lesions in the skin folds dry. If kept moist, you could be at risk for a fungal infection.

https://www.health.com/where-psoriasis-can-develop-12030341

Tips for Finding the Best Shoes for Psoriatic Arthritis

From healthcentral.com 

There’s no one right shoe for PsA-affected feet, but these recommendations can help you find the right fit

If you or someone you love is living with psoriatic arthritis (PsA)—a chronic autoimmune disease that causes inflammation of the joints, tendons, and ligaments as well as skin symptoms (psoriasis)—finding the best shoes goes beyond style, fit, and fashion. In fact, the right shoes can help you battle PsA foot pain, swelling, and tenderness. Proper footwear can also make a difference when it comes to inflammation and joint damage.

“The most important component of foot protection in PsA is to control the underlying systemic [body-wide] inflammation with the correct treatment regimen,” says Elizabeth Schulman, M.D., a rheumatologist at Hospital for Special Surgery in New York City. “However, PsA can also have multiple clinical manifestations in the feet and the right footwear can make a significant difference to prevent mechanical strain that can further trigger inflammation and cause joint damage.”

The number one goal: Finding a fit that provides good arch and toe support, says Dr. Schulman. For more guidance on what to look for, start with these expert-backed tips for finding the best footwear for psoriatic arthritis.

Why Footwear Matters for Psoriatic Arthritis

                                                                                          GettyImages/sf1nks

Simply put: Footwear matters because PsA can do a number on your feet. A recent study of 40 people with PsA in Foot and Ankle Surgery found that 95% of the participants observed the disease in their feet. And while symptoms vary from person to person, the study found PsA in the feet can have an impact on quality of life, leading to pain, deformities, and walking and mobility difficulties.

“Foot issues are a huge problem with PsA,” says Jody Quinn, a patient advocate from Plymouth, MA, who was diagnosed with PsA in 2024. “Before I was officially diagnosed, I had plantar fasciitis, which I eventually found out is a common symptom of PsA. I also had swollen toes, commonly called “sausage like digits,” swollen feet, and ankles along with tremendous pain in the many joints in my feet. The feet are definitely an area of the body where PsA pain can strike and can prevent you from enjoying daily activities.”

The disease often attacks the smaller joints in the feet (the distal interphalangeal joints), the ankle, and the entheses, where tendons and ligaments attach to bone. Issues include:

• Bunions, bony bumps at the base of the big toe, can be painful when the bone presses against your shoes, and affect other toes and ball of the foot, according to the American Academy of Orthopedic Surgeons.

• Dactylitis (a.k.a. “sausage digits”) can cause foot or toe pain, a feeling of “heat” in the foot, skin discoloration, and difficulty moving or bending your toes, according to the Cleveland Clinic.

• Enthesitis, or inflammation in the enthesis, can cause pain and burning where the Achilles tendon attaches to the back of the heel and at the plantar fascia ligament, which stretches along the bottom of your foot, causing plantar fasciitis.

• Hammer/claw toes, caused by damage in joints from chronic inflammation, can result in changes in shape and alignment of the toes.

• Pitting, or shallow or deep holes in the nail plate, often start as a cosmetic issue but can lead to thickening of the toenails or infection due to pressure on the nail bed.

The good news: If caught early, many of these foot issues can be prevented and treated with simple self-care, including investing in the right shoes. “Ideally you care for your feet the way you care for your other body parts,” says Dr. Schulman. “Our feet bear the pressure from the rest of our body so proper hygiene, foot support, rest, and strengthening are key.”

Tips for Buying the Best Shoes for Psoriatic Arthritis

The best shoe for PsA will largely depend on your individual symptoms, so it’s best to check with your rheumatologist or podiatrist for guidance.

That said, both experts and people living with PsA agree that good arch and ankle support, a supportive heel counter (for shock absorption), and a wide and deep toe box are must-haves. “Unsupportive footwear can put extra strain on the ligaments, bones, joints, and tendons leading to worsening inflammation and overtime damage,” says Dr. Schulman.

Sari Priesand, D.P.M., a clinical assistant professor at the University of Michigan in Ann Arbor and spokesperson for the American Podiatry Medical Association (APMA), suggests looking for shoes with the APMA Seal of Acceptance and Seal of Approval, which are reviewed by a group of APMA podiatrists to ensure foot health.

Get Professionally Fitted

Since everyone’s feet are a little different, it’s best to get expert guidance to measure for supportive footwear for PsA, says Dr. Schulman. A proper in-store fitting can make a big difference—and may just become a regular part of your shoe-buying routine. After all, sizing varies among manufacturers and the location of PsA inflammation can change quickly.

If possible, invest in a couple of options based on your daily activities to be sure you’re always as comfortable and supported as possible. For example, Quinn tends to wear clogs to prevent heel pain when her plantar fasciitis flares and boots with a cushioned footbed in the fall and winter to support her ankle and reduce the swelling that often develops during colder weather.

When shopping for shoes, keep in mind that your feet tend to swell throughout the day, so it’s best to schedules fittings later in the day when swelling is more significant, rather than in the morning when feet tend to be less swollen, says Dr. Priesand.

Shop for Shoes with Removable Insoles

Comfort often starts by removing the factory insoles and replacing them with customized orthotics to better support your feet and correct any deformities. Your podiatrist can evaluate your pain points and gait (the pattern of how you walk), and fit you for insoles or orthotics or even create something custom for you. Some insurance companies will cover the cost of customized ones. If not, ask your doctor for an over-the-counter recommendation.

Opt for Lightweight Options

When you pick up a shoe, it should feel light in your hand. Lightweight shoes can help reduce joint fatigue and make day-to-day walking easier. A heavy shoe, on the other hand, will make it harder to lift your foot off the ground, increasing joint strain and potentially altering your gait. “Lightweight doesn’t mean minimalist,” warns Dr. Priesand. Lightweight shoes still need to be supportive. A good test for support: Try to bend the shoe in half. It should only bend at the forefront where the toe bends naturally.

Say Yes to Slip-Resistant Soles

The swelling, inflammation, and deformities that occur with PsA in your feet can change the way you walk, increasing your risk of falls. To help you stand and move around safely, say no to slippery leather soles and instead go for rubber ones or those with a secure grip built into the sole.

Consider Finger-Friendly Footwear

Psoriatic arthritis can cause stiffness and reduced range of motion in the fingers and wrists. If PsA affects your hands, consider Velcro closings or elasticized laces so you can easily slip into your shoes.

Look for Soft and Flexible Uppers

Dr. Priesand suggests looking for shoes with soft, flexible uppers, including materials like neoprene, mesh, or knit fabric, to accommodate any swelling, toe deformities, or skin issues. “Avoid leather because it’s not very forgiving—it doesn’t allow for much movement, which can be harmful,” she says.

When someone with PsA has swollen toes from dactylitis, wider toe boxes and more flexible materials can help prevent excess pressure and avoid stress on the foot, adds Dr. Schulman.

Pay Attention to Heel Height

Overall, it’s best to avoid heels higher than two inches, notes the APMA. More than that and it may affect your balance and stability. High heels also put extra pressure on the arches and stress on joints. If you want a little lift, kitten heels (less than one inch) are the most foot-friendly, especially if they have a generous toe box area and extra cushioning at the front of the shoe.

Test Them Out

Even the best shoes for psoriatic arthritis have to be broken in slowly. Dr. Priesand recommends wearing them for an hour the first day and then increasing by an hour a day for the first week. Check for red spots on your skin and note how your feet feel as they swell throughout the day.

And once you find the right fit, remember to periodically assess the sole for wear and tear—it’s a sign that it’s time to change them or discuss any patterns with your podiatrist, says Dr. Priesand.

“I would recommend replacing shoes every six to 12 months or whenever there are signs of wear,” adds Dr. Schulman.

Alert Your Doctor to Foot Symptoms

If you notice any new or worsening symptoms in your feet, your first step should be to talk to your doctor. Changes in the toes can be a sign that your PsA is advancing or not well-controlled, informing your treatment decisions. “Many people tend to ignore their foot and ankle symptoms until they are severe and preventing ambulation,” warns Dr. Schulman.

Here are a few signs of PsA in your toes and your feet:

• Pain when bending your toes

• Swollen digits

• Tendon attachment pain

• Toenail changes (thickening or lifting of toenails or pitting)

https://www.healthcentral.com/condition/psoriatic-arthritis/best-shoes-for-psoriatic-arthritis 

What to Do About Foot Psoriasis

From healthcentral.com

Psoriasis can be a challenge to manage when it’s on your feet. Experts share the treatments and lifestyle tweaks that can help 

Managing your psoriasis often means taking things like setbacks and treatment plans step by step. But those metaphorical steps get a little trickier if the psoriasis is on your feet.

The chronic skin condition, which happens when the immune system goes into overdrive and triggers skin cells to grow abnormally, can occur on almost any part of the body, including the feet. Often, its signature symptoms include patches of skin inflamed, thick, dry, or scaly skin. Some people with psoriasis also experience small depressions in their toenails called pitting.

Here’s the catch: Research shows that psoriasis on the feet, also known as palmoplantar psoriasis, can be more disabling than psoriasis on other parts of the body because it can easily interfere as someone moves around and goes about normal day-to-day activities. But it doesn’t have to sit you down for good. Here, learn more about the symptoms to look for and get expert advice on how to treat and manage foot psoriasis.

Types of Psoriasis That Affect Your Feet

There are several different types of psoriasis that can affect your feet, just as they can affect other parts of the body. Here’s a breakdown of the four types that are seen most frequently:

Plaque Psoriasis

Plaque psoriasis is the most common type of psoriasis on the feet (it’s also the most common type of psoriasis in general). It looks like thick, scaly, red or pink raised areas of skin (or plaques), often on the bottom of the feet. “These plaques can often cause itching, burning, and discomfort,” says Andrea Hui Austin, M.D., a board-certified dermatologist at Bay Area Cosmetic Dermatology in San Francisco. “The nails may also be affected, with thickening and pitting—which looks like tiny holes on the surface of the nail—or splitting of the nails.”

In people with darker skin, the plaques are rarely red or pink. Instead, they may be various shades of brown, purple, or gray, and may have silvery scales.

Guttate Psoriasis

When someone has guttate psoriasis, they typically break out in small, red, scaly patches often throughout the body (including the feet). The condition often comes on suddenly and people usually develop it after having strep throat or an upper respiratory infection.

Pustular Psoriasis

“Pustular psoriasis is characterized by tiny yellow fluid-filled blisters on the feet,” Dr. Austin says. “This can be extremely painful and can lead to dried scaling on the feet.” Youcan develop pustular psoriasis anywhere on your body, but it’s most common on the palms of your hands and the soles of your feet.

Psoriatic Arthritis

Some people with psoriasis have a form of arthritis called psoriatic arthritis, which involves symptoms like joint pain, swelling, and stiffness. The joint pain can occur anywhere throughout your body, including your toes, heels, tendons, and toenails.

“Psoriatic arthritis can appear concurrently with other forms of psoriasis that affect the feet,” Dr. Austin says.

Symptoms of Psoriasis on Your Feet

Foot psoriasis symptoms can vary from one person to the next and can also be different depending on which type of psoriasis you have. These symptoms are some of the most common, according to Cleveland Clinic:

• Discoloured skin

• Dry skin

• Itching and burning skin

• Thick, scaly, red plaques on the skin

• Tiny depressions in the toenails called pitting

Causes

No one knows exactly what causes psoriasis on the body—including when psoriasis symptoms show up on your feet—but it’s believed that the condition is brought on by a combination of triggers including genetics, an overactive immune system, environmental factors, and skin irritation. “Psoriasis is considered an autoimmune condition whereby the immune system mistakenly targets healthy skin cells and leads to their dysregulation,” Dr. Austin says.

Dermatology Atlas

Dermatology Atlas

DermNet

Triggers

These are a few different factors that can cause psoriasis on the feet or trigger a flare-up:

• Alcohol can trigger psoriasis and make psoriasis symptoms worse, research shows.

• Exposure to environmental factors, like warm and moist environments can injure the skin and trigger a psoriasis flare, Austin explains.

• Family history of psoriasis can make someone more likely to develop psoriasis, including on their feet.

• Obesity can increase someone’s chances of developing diabetes and may also make psoriasis symptoms worse, research shows.

• Smoking can increase your risk of developing psoriasis and may also worsen existing psoriasis, research shows.

Difference Between Foot Psoriasis and Athlete’s Foot

It can be challenging to tell the difference between psoriasis and athlete’s foot since both conditions cause a lot of the same symptoms. But to properly treat whatever is causing your symptoms—especially if you’ve never been diagnosed with either condition—you’ll want to see a dermatologist who can examine your skin.

Though it can be hard to tell apart athlete’s food and psoriasis, one helpful way to differentiate between the two is to pay attention to which area of the feet is affected. “Psoriasis usually involves the top and bottom of the feet,” says Shari Lipner, M.D., a board-certified dermatologist at Weill Cornell Medicine in New York City. “Athlete’s foot involves the bottom of the feet and in between the toes.” Here are a few more differences between foot psoriasis and athlete’s foot, per Dr. Lipner:

• Cause: Foot psoriasis is a chronic autoimmune skin condition that results from an overactive immune system. Athlete’s foot is a contagious fungal infection caused by dermatophytes (fungi that thrives in warm, moist environments).

• Appearance: Foot psoriasis typically appears as red, scaly patches or plaques on the feet. Athlete’s foot usually presents as red, peeling skin between the toes or on the soles of the feet. It may also cause blisters or infected open sores.

• Itching: Foot psoriasis can be itchy, and the affected skin may crack, bleed, or become painful. Itching also happens with athlete’s foot, but it is also often accompanied by a burning sensation.

• Common Symptoms: In addition to redness and scaling, individuals with foot psoriasis may experience nail changes on the toes, such as pitting, thickening, or discoloration. Athlete’s foot is primarily a fungal infection and does not affect the nails.

Treating Psoriasis on Your Feet

Most treatments for foot psoriasis aim to alleviate pain and discomfort and reduce symptom flare-ups. Usually this involves topical treatments and/or light therapy for the affected skin area, or systemic medications that treat psoriasis as a whole.

“Psoriasis of the feet can be challenging to treat due to constant pressure from weight, warm and moist environment in shoes, and daily activities such as walking,” Dr. Austin says. “With the help of a board-certified dermatologist, a successful treatment plan can be established to help a patient overcome their psoriasis.”

Let’s look at some common foot psoriasis treatments:

Topical Treatments

These treatments, applied directly to the affected skin, can help reduce inflammation, slow down skin cell growth, and alleviate itching, providing relief for people living with psoriasis. Common types of topical treatments for psoriasis on feet include:

• Coal tar: Coal tar shampoos (you can use them on your body, too), foams, and ointments are an effective psoriasis treatment that help bring some people into long periods of remission.

• Creams and ointments: Most cases of psoriasis are mild or moderate in severity and can be treated with creams and ointments. These can help bring symptoms like itching and swelling under control.

• Salicylic acid: Salicylic acid has exfoliating properties and can help clear up flaking skin. “Emollients containing salicylic acid can help to soften and flatten the characteristic thick scales of psoriasis,” Dr. Austin says. “They can also help topical prescriptions such as corticosteroids penetrate the skin and provide healing effects.”

• Topical corticosteroids: Available over-the-counter and by prescription, topical corticosteroids are a type of medication that’s available in various forms, including creams, ointments, and gels. They help reduce redness, itching, and inflammation.

Systemic Treatments

Systemic treatments are a type of prescription medication that work throughout the entire body. Some systemic medications commonly prescribed for psoriasis on the feet include:

• Biologics: Biologics target the specific part of the immune system that causes psoriasis flares, Dr. Austin explains. They’re often used as a treatment for people with moderate or severe psoriasis when other treatments like topical creams and corticosteroids don’t help bring symptoms under control.

• Oral corticosteroids: “For more severe cases, oral corticosteroids can be used to manage the immune system from within,” Dr. Austin says.

Phototherapy

Phototherapy, or light therapy, is a treatment used for various skin conditions, including psoriasis. Under the care of a dermatologist, this treatment emits UV light is emitted from a device that’s either full-body-sized or smaller and targeted to a specific area like your feet.

Lifestyle Tweaks

Changing up your lifestyle in some ways can sometimes help manage psoriasis and lower your chances of experiencing a psoriasis flare. You can approach this in a few ways, according to Cleveland Clinic:

• Limiting alcohol: Alcohol can sometimes make psoriasis symptoms worse, research shows. By saying no to that wine or beer, you may be less likely to experience psoriasis symptoms brought on by alcohol use.

• Not smoking: Research shows that smoking can increase your risk of developing psoriasis. It can also make your psoriasis more severe, and you may be less responsive to some treatments. If you quit smoking, some psoriasis symptoms may improve.

• Proper foot care: Wearing breathable socks, washing your feet often, and regularly moisturizing may help prevent flare-ups.

• Reducing stress: Studies have found that reducing stress can play an important role in managing psoriasis.

Takeaways

When psoriasis affects the feet, you may notice symptoms such as redness, thickening of the skin, dryness, and the presence of scaly patches. Additionally, nail abnormalities like small depressions can occur. While plaque psoriasis is the most prevalent type found on the feet, other variations exist. Managing foot psoriasis typically involves making lifestyle adjustments and using topical creams. In severe cases, oral medications may be necessary. If you aren’t sure if the itchy rash on your feet is psoriasis or not, your first step is to make an appointment with your doctor for confirmation.

https://www.healthcentral.com/condition/psoriasis/psoriasis-on-feet