Flexural psoriasis is a form of skin psoriasis that is not infectious but is an auto-immune disease that is triggered by the activation of T-cells in the skin. It is more common in overweight people as it occurs in skin folds that are prone to irritation because of rubbing and sweating.
Flexural psoriasis is also called inverse psoriasis and is a chronic skin condition that with thick, red and silvery scaled skin patches. It is predominant in the armpits, under breasts, groin and other flexion creases like around the genitals and buttocks. While it may occur anytime in life, it commonly appears in the early 20s in both men and women. It is however more commonly found in fair skinned people.
The moist nature of the skin folds makes this psoriasis a bit different from other forms of psoriasis. Instead of having a silvery scale, the scales here are shiny and smooth and may have a crack in the depth of the skin crease.
At times, the plaques get infected with candida albicans fungus at the site of injuries or scars. While psoriasis is a chronic condition that can last for months or years, treating it in the early stages can however reduce the severity of the disorder.
While topical treatments and weak topical steroids can treat flexural psoriasis, it generally recurs on discontinuing the treatment. Phototherapy is however relatively ineffective at treating flexural psoriasis as the folds is hidden from light exposure.
There is no exact cause for flexural psoriasis; there are many factors that can aggravate the condition.
However exposure to some skin stimuli and damage can cause a psoriasis outbreak in people who suffer from this genetic predisposition. Moreover it is at certain times in life that women have a higher tendency of developing psoriasis like during puberty or during or after menopause.
Other common causes and risk factors
- Sun exposure
- Streptococcal infection
- Psychological factors like stress
- Hormonal factors
- Steroids and other medications
Signs and symptoms
This form of psoriasis appears as a smooth but inflamed patch of skin in skin folds like armpits, under breasts and around genitals. Its appearance in skin folds makes it vulnerable to fungal infections and is easily affected by friction and sweat.
The common signs and symptoms of flexural psoriasis
- Sensitivity to sweating and friction
- Nail disorders
- Patches on the same area on both sides of body
- Red and raised skin patches mainly on buttocks lower back, knees, elbows and scalp.
- Your doctor will be able to diagnose flexural psoriasis through a physical and visual examination. In case your joints are infected by the condition, you may have to undergo a blood test.
- There are possible causes for complications in flexural psoriasis like secondary fungal infections like Lichenification, a type of eczema that results from the rubbing of skin. If the psoriasis is in the vulva and groin area, there may also be discomfort while having sex.
- Moreover, the rubbing, heat and sweat can lead to skin irritation while topical steroid creams thins the skin if used for long periods of time. Nerve fiber stimulation below the skin can also lead to severe itching.
There are multiple treatment options available for those suffering from flexural psoriasis. However there is a chance of the condition appearing after a few months or years as psoriasis is a skin condition that is still not curable.
- Sunshine is a natural and rather effective psoriasis treatment option. In fact, many psoriasis sufferers see remarkable improvements during sunny holidays.
- Calcipotriol cream is a safe flexural psoriasis treatment option that should be applied twice every day.
- Severe cases of flexural psoriasis may require systemic drugs like methotrexate for treating the condition.
- Some patients prefer using topical steroids as they are not only clean and easy to use, but also soothing and effective for treating flexural psoriasis.
- Bed rest helps a lot at treating flexural psoriasis.
- Emollients like keratolytic agents are also effective for treating this skin condition.
- Vitamin D compound creams provide great relief from the condition if applied every day to the skin folds.
- Make it a point to use moisturizers instead of soap to prevent the skin form getting too dry.
- Drugs like Amevive help at treating flexural psoriasis as it blocks the activation of T-cells in the immune system. It thus prevents skin cells from growing too fast to lead to psoriasis lesions.
- Antibodies like Efalizumab, aspirin and natural antidepressants like Gingko Biloba, 5 HTP and St. John’s Wort also prove helpful.
As flexural psoriasis is a metabolic illness, a cleansing fast of fruit juice and water for a week may be recommended by some doctors as the first step in the treatment process. During this fast, it is advised to avoid taking citrus fruits and juices.
Instead, take more of carrots, grapes and cucumbers during the fast.
Make sure you apply all creams and ointments to the affected area as regularly as recommended by your doctor. Moreover, check with your doctor before using a cream recommended for other areas of psoriasis before applying it in skin creases. This is because the skin creases are delicate, and tend to get irritated by some preparations. It is also better to intermittently use treatments to control psoriasis.
- Make sure you pat dry the infected areas after bathing and showering.
- Never rub vigorously with a towel as it only aggravates the condition.
- Wear more of cotton underclothes as they are comfortable and better for your skin.
- Women should adapt to wearing stockings and avoid wearing tights.
- Always wear loose-fitting clothes and avoid all tight fitting ones.
- You get relief from the itching by taking cold showers and cold presses, and by using bath oils containing tar.