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Profile: Inverse Psoriasis (flexural psoriasis)

Definition: This type of psoriasis affects the body's fold areas and skin (armpits, under-breast folds, navel, groin fold, intergluteal cleft, space between toes or fingers, inguinal). In babies, this inverted psoriasis is referred to as "nappy psoriasis" with erythematous plaques located directly under the nappy. It manifests as red, highly inflammatory lesions, well-defined and less scaly on the surface, and associated with sensations of burning and itching. However, local conditions (heat, sweating, friction) promote skin maceration which can lead to a fungal (candidiasis) or bacterial (streptococcal) infection, the absence of thick scales, constant irritation and fissuring. Rarely isolated, it affects between 3 and 7% of patients with psoriasis.

Internal and external causes: Genetic predisposition; immune system abnormalities; overweight (high risk of development); humid environment (perspiration); friction; intake of certain medications; infections; skin injuries.

How to reduce or eliminate: Application of mild to moderate class dermocorticoids (first intention); favouring the wearing of loose cotton clothing; prescription of antibacterial or antifungal medications in addition to the standard treatments for psoriasis (in case of infection); treatment by phototherapy (in case of moderate to severe inverse psoriasis); prescription of systemic medications orally or by injection such as cyclosporine or methotrexate (if no improvement).

Preventative steps to take: /