Can I Have More Than One Type of Psoriasis? A Q&A with Dr. Truong

Allison Truong, M.D.: The simple answer is yes, you can have more than one type of psoriasis.

There are several types of psoriasis that affect the skin, any of which can be found at the same time on the same person.

One of the most common pairs: plaque psoriasis, which is characterized by red, scaly plaques, and guttate psoriasis, which causes small pink-to-salmon-colored spots on the torso, legs, and arms. Any virus or disease that triggers the immune system—strep throat and now COVID-19—can trigger additional psoriasis in some people.

People who have inverse psoriasis, which causes smooth, shiny, itchy red patches in areas where the skin rubs together, such as under the breasts, armpits, and groin, are susceptible to having plaque psoriasis outbreaks on other parts of their body, as well.

Plus, about half of all people with plaque psoriasis also have psoriasis of the nails at some point. Some people develop plaque psoriasis and nail psoriasis at the same time—some will start with just one of the two and then develop the other later.

According to the National Psoriasis Foundation, up to 30% of people who have psoriasis eventually develop psoriatic arthritis, a psoriatic disease that affects the joints. Some people develop arthritis first and psoriasis later.

The good news is that the various types of skin psoriasis don’t necessarily require differing treatment and management recommendations. So for example, what your dermatologist recommends for treating your plaque psoriasis should also help with any other types of psoriasis, if you develop them. However, you should see a rheumatologist to optimize your treatments for psoriatic arthritis.

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