Inverse psoriasis

November 12, 2012

Inverse psoriasis

Psoriasis is a very painful skin condition and can be very pruritic and uncomfortable, but what is inverse psoriasis?

Inverse psoriasis is an uncommon condition which is, in many ways, similar to psoriasis. However inverse psoriasis does not appear in visible areas of the body but rather in the skin folds, armpits and groin where the rash will also cause both pain and itching which may cause the patient great distress.


The rash associated with inverse psoriasis does not have the same scaliness found in regular psoriasis but rather appears as a red and tender area. The painful, itching of inverse psoriasis is greatly worsened by perspiration and friction which are difficult to avoid in the areas of presentation –

  • Groin

  • Armpits

  • Under the breasts

  • Under the buttocks

  • In the skin folds around the genitals

  • In deep skin folds around the waist, stomach and thighs


Due to the sensitivity of the areas affected by inverse psoriasis effective treatment may be problematic. The recommended treatment is with topical medical medications such as Protopic and Elidel which are prescription strength and contain no cortisone – known to have an adverse effect on sensitive skin. Protopic and Elidel, whilst being the preferred first choice for most dermatologists, carry a warning that they are only suitable for short term use due to their possible side effects.

As with regular psoriasis the use of Ultra Violet B light treatment has been found to be beneficial. This treatment involves the patient standing, unclothed, in a light box and being bathed in the UVB rays.

Some individuals find that their inverse psoriasis is greatly worsened by moisture; the use of Castellani’s paint of Castederm is generally prescribed, with patients also able to buy Domeboro astringent soaks over the counter.

In extremely stubborn cases of this condition the medical practitioner may well prescribe a course of Enbrel or Remicade injections.

Risk factors

Most cases of inverse psoriasis occur in patients who already suffer with regular psoriasis – between 2 and 6% of psoriasis sufferers will develop the inverse variety. It appears to be more prevalent in overweight patients. Research indicates that that overweight patients experience increased severity of inverse psoriasis.

Some experts maintain that any severe irritation accompanied by redness in the genital area could be inverse psoriasis Рeven in individuals who have never been diagnosed with regular psoriasis. It is possible to have mild psoriasis which is assumed to be dandruff, for example, and therefore remains undiagnosed until inverse psoriasis flares up’.

Living with inverse psoriasis

Individuals living with any skin condition know that the treatment of that condition will have a huge impact on their lives. The same is true for inverse psoriasis, it is essential that patients are fully involved in their own treatment program, that they follow medical advice carefully and do all that they are able to do in order to avoid any flare ups.

Any individual with a chronic condition will always benefit from joining with others with the same condition, sharing of information; hints, techniques and emotional support are all beneficial to patients dealing with the difficulties of life with inverse psoriasis.


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