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Inverse (Flexural) Psoriasis

Smooth, shiny red psoriasis plaques in body folds without typical scaling.

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Dermatoloji department. Book Appointment →

What is Inverse (Flexural) Psoriasis?

Inverse (intertriginous) psoriasis is a less common variant of psoriasis that affects the body folds, including the axillae, inframammary creases, groin, perianal area and intergluteal cleft. The lesions are smooth, shiny and bright red, lacking the typical silvery scale because of moisture and friction.

It can be misdiagnosed as candidiasis, intertrigo, contact dermatitis or seborrheic dermatitis. Often it coexists with plaque psoriasis at other body sites, helping to confirm the diagnosis.

Inverse psoriasis significantly impacts quality of life because of itching, burning, soreness and embarrassment. It is more frequent in obese patients due to increased skin folds and friction.

Symptoms

Smooth, shiny, well-demarcated red plaques in skin folds
Absence of typical silvery scaling
Itching and burning
Maceration and fissuring of the cleft
Lesions in axillae, groin, inframammary and intergluteal areas
Worsening with sweat and friction
Coexisting plaque lesions elsewhere

Risk Factors

Obesity
Diabetes mellitus
Excessive sweating
Friction and skin-on-skin contact
Family history of psoriasis
Heat and humid environments
HIV infection or immunosuppression

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Persistent red rash in body folds
  • Failure of antifungal creams
  • Itching, burning or fissuring of skin folds
  • Coexisting plaques on elbows or knees
  • Recurrent intertrigo with no infection
  • Significant impact on daily life or sexual activity

Treatment Methods

01
Low-potency topical corticosteroids for short courses
02
Topical calcineurin inhibitors (tacrolimus, pimecrolimus) for long-term use
03
Vitamin D analogues (calcitriol)
04
Antibacterial or antifungal therapy for secondary infection
05
Weight loss and moisture control
06
Systemic biologics for severe or refractory disease
07
Loose, breathable clothing and barrier creams

Which Department to Visit?

You can visit our Dermatoloji department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

Learn About Dermatoloji Department

Let us help you

You can make an appointment with our specialists or contact us for your concerns.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.