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Inverse psoriasis, also known as intertriginous psoriasis, is a type of psoriasis that forms in the folds of your body. This includes areas like your armpits, groin and under breasts. It can also occur between your buttocks and genitals.
It’s characterized by smooth, red patches that may crack or bleed. Unlike plaque psoriasis, inverse psoriasis doesn’t have the typical silvery scales associated with it. It tends to be less severe than other types of psoriasis. However, it may be more difficult to treat because of its location in skin folds.
If you have symptoms of inverse psoriasis that don’t go away after one or two weeks, make an appointment with your doctor. They’ll diagnose you based on the appearance of your skin and a physical examination. You won’t need any lab tests or imaging studies for a diagnosis.
Inverse psoriasis is generally treated with topical medications. Corticosteroids are usually used first. If they don’t work well enough alone, they may be combined with calcipotriol (Dovonex) or tazarotene (Tazorac).
Onset and Symptoms
More than just the name, “Inverse Psoriasis” is a title I think describes the condition well. It’s an inverse – meaning that it’s applied to skin conditions instead of to diseases. The word “psoriasis” refers to a group of diseases that all have something in common: the buildup of excessive amounts of skin cells, which causes redness and irritation. The main factor that makes psoriasis different from other skin diseases is that it seems to be affected by genetics and when you have psoriasis, you’re at risk of having children with the same condition.
Since they’re genetically related, people often wonder whether inherited psoriasis might cause inverse psoriasis. The answer is no—inverse psoriasis is caused by environmental factors, not genetics. With that said, there are some differences between the two—the main one being that the symptoms of inverse psoriasis are very similar to those of pure psoriasis (which is why it’s sometimes difficult to tell them apart), but with slightly milder symptoms than those who have pure psoriasis.
As for onset, I believe it starts for most at about age 35 or older since most people don’t realize they have it until then. Common onset symptoms include:
-Redness in patches on your skin or areas on your body where you haven’t had it before
-Sores or lesions on your skin (that may itch and burn)
-The first sign may be red marks on your legs or arms; over time these can become full scale patches of scarring
-Scaling or thickening of your skin
Treatment Options
The treatment of inverse psoriasis depends on the severity of the disease. Some patients require topical therapy, while others need oral medications and/or phototherapy.
Topical Treatments:
Topical therapies, such as corticosteroids or calcipotriene (Dovonex), can be used to treat mild to moderate disease. However, these treatments may not be effective in patients with severe disease because they do not penetrate thick plaques very well.
Phototherapy:
For patients with more extensive inverse psoriasis, phototherapy is often the treatment of choice. Phototherapy uses natural or artificial light to slow the growth of skin cells affected by psoriasis. Ultraviolet B (UVB) is particularly effective for inverse psoriasis.
Systemic Therapy:
Systemic medications are used for patients with severe forms of inverse psoriasis that fail to respond to other treatments.
Methotrexate: Methotrexate is a medication that interferes with the growth of skin cells and suppresses inflammation. It is usually taken once a week and may take several weeks to months before its effects are seen. Side effects include nausea, upset stomach, and liver damage.
Inverse or flexural psoriasis treatments includes
Corticosteroids
A group of medications that are used both to prevent and treat many different conditions. They’re often prescribed to people who suffer from asthma, allergies, inflammatory diseases, and autoimmune disorders. The most common form is prednisone, which is typically used to treat rheumatoid arthritis, lupus, and other autoimmune diseases.
Calcipotriene
A synthetic vitamin D analogue used as a topical treatment for psoriasis. The drug has been shown to be effective in the treatment of plaque psoriasis, scalp psoriasis, palmoplantar pustulosis, and inverse psoriasis.
The mechanism of action for calcipotriene is not fully understood. It appears to stimulate cell differentiation, keratinocyte migration, and epidermal proliferation. Calcipotriene also increases the turnover of skin cells and reduces inflammation.
Problems with calcipotriene include local irritation, burning, itching, scaling, and erythema; rare cases of acneiform rash have been reported. The drug should be avoided in patients with hypersensitivity to vitamin D or its analogues or any component of the formulation. Calcipotriene may increase the risk of hypercalcemia when used in combination with other drugs known to do so (e.g., thiazide diuretics). It should be used cautiously in patients with hypercalcemia or a history of hypercalcemia. In addition, calcium and phosphorus levels should be monitored during therapy.
Coal Tar
Most people know that Coal Tar is the type of paint that was used to paint the exterior walls of the Titanic and it’s also used in the automotive industry to create a durable finish. Even though we all know this, there are still some people out there who have no idea what Coal Tar is or why they should care. One thing you need to know about Coal Tar is that it is actually a derivative of oil. The chemical engineers behind its creation made a synthetic fuel out of oil, which they then mixed with coal tar. In most cases, the coal tar is mixed with linseed oil or some other kind of solvent, which aids in the application process and enables it to be applied evenly on different surfaces.
Castellani's Paint
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Light Therapy
Also known as phototherapy or heliotherapy, is a treatment that uses natural or artificial light to treat some skin conditions. It is often used to treat the symptoms of Seasonal Affective Disorder (SAD), such as depression and fatigue; the effectiveness of light therapy in treating these symptoms has been largely established. Light therapy is also used to treat other conditions, including psoriasis, acne, and vitiligo.