Psoriasis is an inflammatory condition of the skin caused by an abnormal immune system that makes skin cells multiply rapidly. New cells push to the skin surface and form dry silvery scales that appear as reddish patches and raised sores. The inflamed skin radiates an itchy feeling and becomes painful to touch. Psoriasis is chronic in nature and appears and disappears frequently. It is not contagious. Psoriasis can occur in any part of the body. To date, no cure has been found. Inverse psoriasis is a subtype of psoriasis which affects the parts of the body where the skin folds over itself like the armpits, elbows, groin, buttocks, and beneath the breasts.

The Key Differences Between Psoriasis and Inverse Psoriasis

In psoriasis, the abnormal skin (anywhere in the body) appears raised and forms a thick scaly crust which is reddish in color. The thickening of the skin in affected areas may cause the skin to dry up and crack forming blisters and sores. Reverse psoriasis, on the other hand, appears only where the skin folds over itself and skin to skin friction becomes a possibility.

The combination of sweat (moisture) and friction aggravates inverse psoriasis to produce moist, shiny, reddish patches of smooth inflamed skin. These patches will not be raised as in psoriasis. It is noticed that inverse psoriasis appears more in people affected by plaque psoriasis which is characterized by raised crusty skin lesions. Unlike plaques that can form anywhere, inverse psoriasis is restricted to small patches inside skin folds.

Psoriasis appears to be aggravated by immunodeficiency disorders triggered by strep throat, respiratory tract infections or stress. Inverse psoriasis is more commonly associated with yeast and bacterial infections. The irritation of skin rubbing against skin and the moisture produced by sweating creates the ideal environment for fungi to thrive in inverse psoriasis.    

What Are the Visible Symptoms of Inverse Psoriasis?

  • Red, shiny, smooth patches of skin with lesions seen wherever the skin folds over the skin.
  • Prominent locations are the armpits, elbows, below the breasts, the groin and folds of the buttocks.
  • Skin folds at the tips of fingernails appear thickened and ridged.
  • Joints may become stiff and painfully swollen.
  • The patches may linger for weeks or months and then disappear completely.

Knowing What Triggers Psoriasis Helps You Guard Against Inverse Psoriasis

A trigger is any condition within the body or an external factor that sparks psoriasis and makes it chronic. Inverse psoriasis may then develop as collateral damage:

  • Respiratory tract infections.
  • A skin inflammation aggravated by sunburn; a bug bite, cut or bruise that takes some time to heal.  
  • Mental stress, or chronic depression.
  • Heavy smoking
  • Heavy drinking
  • Sustained deficiency of Vitamin D (the sunshine vitamin)
  • Medications used for the treatment of bipolar disorder, high blood pressure and malaria.

Certain Individuals Are Predisposed to Inverse Psoriasis

Though inverse psoriasis commonly occurs in a large spectrum of the population, there are certain individuals that are prone to the ailment:

  • If a parent or close relative suffered psoriasis, your chances of suffering the ailment are higher.
  • People with compromised immune systems like HIV patients are more prone to psoriasis. Any chronic respiratory ailment affecting children and adults can produce symptoms of psoriasis.
  • Mental stress is known to weaken the immune system and can trigger episodes of psoriasis.
  • Obese people develop considerable skin overlap all over the body, especially in the groin and joints of limbs. This exposes them to inverse psoriasis that thrives within skin folds.
  • Smoking is known to trigger psoriasis and heavy smoking makes the symptoms worse.

How Do We Treat Inverse Psoriasis, and What Are the Lifestyle Changes Involved?

Inverse psoriasis is aggravated by yeast and bacterial infections that find an ideal environment in the warm, moist, and bruised areas inside skin folds. For this reason, doctors use a combination of topical antibiotic creams, moisturizers, and steroids to combat the condition. The other medical options are:

Light Therapy (UVB)

UVB rays are normally emitted by the sun and overexposing yourself to UVB causes sunburn. Ironically, the same rays offer a widely availed option for treating inverse psoriasis. UVB rays partially heal psoriasis by blocking its main cause – the abnormal growth of skin cells. Phototherapy for psoriasis should be done only under the supervision of a qualified doctor. It requires repeat sessions, exposing the affected parts to UVB radiation in controlled doses.

Systemic Drug Treatment

If you’re suffering from psoriasis in moderate to high severity, and topical creams, antibiotics, and light therapy are not giving you results, your doctor may prescribe systemic drugs. The word systemic refers to the way the drug is administered – taken orally in liquid form or as pills, or by way of injections or through an intravenous drip.  

The drugs used are called biologics. These are large protein molecules that block the harmful action of an overactive immune system. When the immune system speeds up cell multiplication, a biologic slows down the process. This protects healthy cells from being destroyed. The biologics treatment requires multiple sessions, and improvements are slow and gradual.

Lifestyle Changes Needed to Combat Psoriasis

  • Frequent changes of light airy cotton clothing increase one’s comfort levels.
  • Avoid tight tops and close fitting undergarments that make you sweat. Frequently powder the affected areas to absorb moisture and control itching. Cornstarch, zinc oxide, and baking soda can provide relief from soreness.
  • Quit smoking and avoid alcohol. Both void the benefits of treatment.
  • Reduce weight. Try to come as near as possible to your ideal body mass index.
  • Switch to a heart-healthy vegetarian diet, avoiding gluten-rich foods.
  • Remaining active improves the healing process.

Inverse Psoriasis May Complicate an Existing Condition or Trigger New Diseases

If psoriasis is not treated and controlled, you may worsen existing health issues and develop new diseases:

Psoriatic Arthritis

The rapid development of new cells makes joints stiff, painful, and immovable. The patient becomes immobile and largely bedridden.

Psoriasis Creates Vision Complications

Psoriasis affected individuals are prone to eye disorders like conjunctivitis (inflammation of the eyelids), blepharitis (inflammation affecting eyelashes and tear ducts) and uveitis (inflamed middle layer of the eye). Severe symptoms are dangerous enough to cause loss of vision.

Psoriasis Aggravates Obesity

It is noticed that severe psoriasis aggravates obesity in individuals. The reverse also applies. Obese people are more prone to inverse psoriasis. The link between the two conditions is still unclear. It is possible that people affected by psoriasis gain weight due to inactivity. And obesity creates larger skin folds which can harbor inverse psoriasis pathogens.  

Elevated Blood Sugar Levels in Psoriasis Patients

Psoriasis has a strong correlation to high obesity, high cholesterol levels, high blood pressure, and cardiovascular disease. This prepares the ground for the onset of Type 2 diabetes.

Psoriasis Hikes Blood Pressure

Research indicates that more than 60 percent of people with psoriasis report higher blood pressure.

Psoriasis Patients Are Prone to Cardiovascular Disease

If high blood pressure correlates with higher cholesterol levels, psoriasis patients may become prone to heart disease. Certain treatments may also trigger irregular heartbeat and strokes.

Psoriasis May Activate the Metabolic Syndrome

This is a term used to describe five conditions that precipitate heart attacks and strokes; increased blood pressure, elevated blood sugar levels, fat deposition around the waist, high triglyceride levels, and low levels of good HDL cholesterol.

Psoriasis Associated With Other Autoimmune Diseases

Symptoms of celiac disease (an immune reaction to gluten), sclerosis (hardening of tissues) and Crohn’s disease (inflammatory bowel disease) worsen with psoriasis because of underlying immune deficiency.

Psoriasis Patients Face a Higher Risk of Acquiring Parkinson’s Disease

The neurological condition that affects the movement of the limbs worsens in patients afflicted by psoriasis.

Kidney Disease

Moderate to severe psoriasis patients are twice as likely to develop some form of kidney impairment.

Emotional Stress

The visually unsightly skin flare up in psoriasis damages self-esteem and increases depression. Such people tend to face isolation in society.

Conclusion

Psoriasis is a serious ailment that requires immediate medical attention. Never make the mistake of ignoring the symptoms as an ordinary skin itch that will go away. Avoid self-medication and over the counter prescriptions that do more harm than good. Never apply oils, skin creams or lotions without consulting a dermatologist. The skin is the largest organ in the body and demands the greatest care. Keep yourself well informed about psoriasis care. Changing one’s lifestyle, changing the diet, and losing weight give maximum relief to psoriasis sufferers.