MNT Psoriasis Progression Guide Moderate to severe psoriasis

Psoriasis Progression Guide

More widespread skin symptoms

More frequent flares

Systemic inflammation

Nail psoriasis

Other related conditions

Psoriatic arthritis

Psoriasis may also affect mental health. A person can talk with a doctor to learn how to manage the risks and let the doctor know if they notice changes in their health.

Psoriasis symptoms improve during periods of remission and worsen during periods of relapse, or flares. More frequent flares may indicate that the condition is progressing or the person needs a change in treatment. One of the goals of treatment is to limit flares.

Psoriasis can cause systemic inflammation throughout the body, which may affect the skin and other organs. Increased systemic inflammation may be a sign that psoriasis is progressing. Without treatment, systemic inflammation may damage the eyes, joints, heart, or other organs.

An estimated 40–50% of people with psoriasis have nail symptoms, such as pitting, crumbling, or separation from the nail bed. These symptoms may affect one or more nails on the fingers or toes. People with nail symptoms are more likely to have severe skin and joint symptoms, but some people develop nail symptoms alone.

Psoriatic arthritis (PsA) can cause swelling, stiffness, and pain in the joints and areas where tendons attach to bones. PsA affects roughly 30% of people with psoriasis, typically starting within 7–10 years after skin symptoms begin. Some people develop joint symptoms before skin symptoms.

Psoriasis is most likely to affect the skin on the elbows, knees, scalp, or lower back, but it may also affect other areas. It may involve more skin over time. Moderate psoriasis typically affects 3–10% of the body surface area (BSA). Severe psoriasis typically involves more than 10% of the BSA or particularly sensitive areas such as the hands, feet, scalp, face, or genitals.

type 2 diabetes

Psoriasis increases the risk of other chronic conditions, such as:

chronic kidney disease

heart disease

non-alcohol-related fatty liver disease