A Guide to Most Common Psoriasis Locations (With Pictures)

Facial psoriasis commonly affects the frontal hairline and forehead, but it can appear on any part of the face, including the skin between the nose and eyes, or between the nose and upper lip. In the image above, the lesions are on the cheeks and the jawline.

These facial lesions are often mild and diffuse, spreading over a larger area rather than being concentrated in one spot. This can make them more challenging to treat, as they may not respond as well to localized treatments. 

Facial psoriasis affects about 50% of people with psoriasis, making it a common and significant aspect of the condition. The appearance of lesions on the face can be particularly embarrassing and can significantly impact self-esteem, especially when the lesions are visible. This can lead to social anxiety, avoidance of social situations, and a general feeling of self-consciousness. 

Psoriasis can also affect the eyelids, causing mild erythema (redness) without excessive scaling. This can lead to a subtle but noticeable redness around the eyes, which may not be as prominent as the typical scaly patches seen on other parts of the body. 

In rare cases, eyelid lesions can become more severe, leading to dry and crusty edges that can be painful. This can cause discomfort and irritation, especially when the eyes are exposed to light, which can exacerbate the symptoms. 

The pain and discomfort can be particularly noticeable when blinking, rubbing the eyes, or when the eyes are exposed to bright light, such as when outdoors or in front of a computer screen. In severe cases, eyelid psoriasis can even affect vision, making it difficult to read or perform tasks that require clear vision.

Lesions may appear around the ears, including the external ear canal. Ear lesions tend to be itchy and can be more severe than those on other parts of the body. This is because the skin in the ear canal is particularly sensitive, and the constant rubbing and movement of the ear canal can exacerbate the symptoms. 

The itching can be intense and persistent, causing significant discomfort and disrupting daily activities. Additionally, ear lesions can cause pain, especially when the ears are exposed to water or other irritants. This can occur during activities such as showering, swimming, or even just washing the hair. The pain can be sharp and stabbing, making it difficult to tolerate.

Between 12% and 16% of people with psoriasis have palmoplantar psoriasis, making it a significant and common subtype of the condition. Effective treatment is crucial for managing the symptoms and preventing complications. Topical treatments, such as creams and ointments, are often used to alleviate the symptoms, while systemic medications and phototherapy may be necessary for more severe cases.

Palmoplantar psoriasis is a chronic and recurrent condition involving cracking, blistering, and swelling on the palms of the hands and soles of the feet. This type of psoriasis can cause significant discomfort and pain, particularly when walking or performing tasks that require hand or foot movement.

The symptoms can be debilitating, making it difficult for individuals to perform even simple daily activities. The constant cracking and blistering can also lead to secondary infections, which can further complicate the condition and increase the risk of complications. Additionally, the swelling can cause the skin to become thick and rigid, making it difficult to bend the fingers or toes.

Nail changes are common in psoriatic patients, occurring in about 50% of cases. These changes often appear as pitting, onycholysis (separation of the nail from the nail bed), and discoloration. This can lead to nail loss and significant cosmetic concerns. 

The condition can also cause the skin to become dry and scaly, which can be particularly uncomfortable in the palms and soles where there is constant friction and movement. While these changes are not specific to psoriasis, they can be a key indicator in diagnosing the condition and distinguishing it from other ailments. Nail changes can significantly impact daily activities such as writing and dressing.

The butt crack is another psoriasis locations where  the skin folds, which is why it is common to have psoriasis lesions at the butt crack. Butt crack lesions, just like psoriasis lesions in the armpit and genitals, are closely associated with Inverse Psoriasis. At our clinic, we use creams to manage lesions at the butt crack.

Psoriasis can also affect skin folds, such as in the skin folds under the breasts. These areas are often irritated by rubbing and sweating, leading to redness, itching and pain. The skin under the breasts can become thickened and scaly, causing discomfort and disrupting daily activities.

Auspitz Sign

A key characteristic of psoriasis is the Auspitz sign, which is bleeding that occurs upon removing the deepest layer of scale from the surface of psoriatic plaques. This sign helps differentiate psoriasis from other conditions. The Auspitz sign is a crucial diagnostic feature of psoriasis, as it indicates the presence of hyperkeratosis (excessive skin thickening) and parakeratosis (abnormal keratin production). When the scale is removed, the underlying skin is often inflamed and prone to bleeding, which is characteristic of psoriasis.

Pompholyx Eczema

Palmoplantar psoriasis can be challenging to differentiate from pompholyx eczema. However, the presence of the Auspitz sign can be a significant clue in making the correct diagnosis. Pompholyx eczema, also known as dyshidrotic eczema, is a type of eczema that affects the palms of the hands and soles of the feet. It is characterized by small, itchy blisters that can be painful. Unlike psoriasis, pompholyx eczema does not typically exhibit the Auspitz sign. The absence of bleeding upon scale removal can help distinguish pompholyx eczema from palmoplantar psoriasis.