What are These Itchy, Scaly Patches on My Elbows?

Psoriasis is a skin disorder characterized by the skin cells multiplying up to 10 times faster than normal. As cells reach the skin surface and die, their volume causes raised, red plaques covered with white scales. It is commonly found on knees, elbows and the scalp and can also affect the torso, palms and soles of the feet.

Symptoms of psoriasis vary depending on the type. For instance, plaque psoriasis, the most common type, includes:

Plaques of red skin, often covered with loose, silver-colored scales; these lesions may be itchy and painful, and they sometimes crack and bleed. In severe cases, the plaques of irritated skin will grow and merge into one another, covering large areas.

  • Disorders of the fingernails and toenails, including discoloration and pitting of the nails; the nails may also begin to crumble or detach from the nail bed.
  • Plaques of scales or crust on the scalp

Other forms of psoriasis include:

  • Pustular psoriasis, characterized by red and scaly skin on the palms of the hands and/or feet with tiny pustules
  • Guttate psoriasis, which often starts in childhood or young adulthood, is characterized by small, red spots, mainly on the torso and limbs. Triggers may be respiratory infections, strep throat, tonsillitis, stress, injury to the skin, and use of anti-malarial and beta-blocker medications.
  • Inverse psoriasis, characterized by bright red, shiny lesions that appear in skin folds, such as the armpits, groin area, and under the breasts
  • Erythrodermic psoriasis, characterized by periodic, fiery redness of the skin and shedding of scales in sheets; this form of psoriasis, triggered by withdrawal from a systemic psoriasis treatment, severe sunburn, infection, and certain medications, requires immediate medical treatment, because it can lead to severe illness.

Several things can make symptoms worse, depending on the type of psoriasis. These factors, or triggers, include:

  • Cold
  • Dry climates
  • Stress
  • Infection
  • Skin injury
  • Certain medicines

It is important to avoid triggers. A few cases of psoriasis may go away without treatment. But it's usually best to treat psoriasis so that it doesn't get worse. If it becomes severe and widespread, it may be much harder to treat. The severity of psoriasis is indicated by the amount of redness and scaling, the thickness of the large areas of raised skin plaques, and the percentage of skin that is affected.

Psoriasis can be an uncomfortable, at times disfiguring and often difficult to treat. Medicines and other therapies can help but there is no cure. Psoriasis can cause a lot of stress and affect how a person feels about themselves. Seek information or counseling from a family doctor.  

By Sarah Haroldson, MD, family physician at ThedaCare Physicians-New London