Rupioid psoriasis is a rare form of psoriasis that causes painful plaques on the skin. It is an autoimmune disorder that has no cure but is treatable with topical creams and ointments.

Psoriasis is a skin-related disease that affects more than 8 million people in the United States. It occurs when something triggers the immune system to make too many new skin cells. The cells build up on the skin to cause plaques, which are raised, scaly patches.

Rupioid psoriasis is a rare type of plaque psoriasis. It causes skin plaques with a distinctive cone shape.

This article discusses the symptoms, causes, and treatment of rupioid psoriasis.

Psoriasis is an autoimmune disease that causes scaly and often itchy skin rashes. It affects 125 million people worldwide, which equates to about 2% of the total population.

There are several types of psoriasis, of which plaque psoriasis is the most common. Another name for plaque psoriasis is psoriasis vulgaris. It causes raised, inflamed, scaly patches on the skin that can be tender and itchy. Almost 90% of people with psoriasis have plaque psoriasis.

Rupioid psoriasis is a type of plaque psoriasis in which the plaques form cones that resemble limpet shells. Some people refer to this condition as “coral reef” psoriasis due to the cone-like appearance of the plaques.

Most people with plaque psoriasis develop sore, raised patches of skin with a silvery crust on top. The shape and size of the plaques are different for people with rupioid psoriasis.

Rupioid plaques typically form thick circles with clearly marked edges. The layers of skin build up to form a distinctive cone or shell-like shape. The plaques are usually quite small, typically having a diameter of 2–5 centimeters.

Rupioid describes the color of the plaques, which are darker than the plaques in other types of psoriasis. It comes from rhupos, the Greek word for filth.

Psoriasis plaques can occur anywhere on the body, but they are usually on the knees, elbows, torso, or scalp. The rashes tend to be symmetrical, affecting both sides of the body.

The best types of treatment depend on the severity of the rashes, as well as the person’s age and general health. Doctors tailor the treatment plan to the individual, and a combination of treatments is sometimes necessary.

Doctors may suggest trying topical treatments, such as creams and balms, which a person can apply directly to the skin. However, these treatments may not be effective because of the thickness of the plaques.

Doctors may prescribe systemic rather than topical treatments to people with rupioid psoriasis. While topical treatments target specific areas, systemic treatments work throughout the whole body.

Some people might receive methotrexate, a drug that can slow the production of skin cells. Doctors will also schedule regular blood, liver function, and kidney function tests to monitor for possible side effects.

The causes of rupioid psoriasis are still unclear. However, the condition occurs as a result of the immune system malfunctioning. Something prompts the immune system to speed up skin cell production, and the extra skin cells rise to the surface, where they form plaques.

People with psoriasis typically report that certain factors trigger their symptoms. These factors vary from person to person but can include:

  • stress
  • infections, particularly strep throat
  • injury to the skin
  • frequent or excessive alcohol consumption
  • certain weather conditions, such as dry and cold climates
  • some prescription medications

People can get psoriasis at any age, but it is more common in adults than in children. Most people develop symptoms between the ages of 15 and 25 years. There is also a second peak in the risk of psoriasis diagnoses between the ages of 55 and 60 years.

Treating psoriasis with systematic medications presents some problems. For example, methotrexate can cause several side effects. These side effects can be severe, such as kidney or liver problems.

People with psoriasis have a higher risk of developing other conditions, such as:

Some of these conditions are treatable with lifestyle changes or adjustments to medications. Regular screening can help catch these conditions early and improve treatment outcomes.

Rupioid psoriasis causes a distinctive rash, which helps a dermatologist identify the disease. However, the rash is not unique to this condition, and doctors may need to perform additional tests to rule out other conditions, such as histoplasmosis, secondary syphilis, or crusted scabies.

A skin biopsy is sometimes necessary to confirm the diagnosis if the condition presents in an unusual way.

There is currently no cure for psoriasis, and many people will require lifelong treatment to manage the symptoms. Doctors can prescribe treatments to reduce symptom flare-ups and lessen the chances of them occurring again.

A dermatologist may suggest various skin care tips, including regularly using moisturizers and taking steps to avoid skin injuries and sunburn. Identifying and avoiding triggers can also reduce the risk of flare-ups and help people manage their symptoms.

The symptoms and disease progression of plaque psoriasis are difficult to predict, which can add to the psychological burden of the condition. For example, it may cause problems with self-esteem, anxiety, or depression. A doctor can provide guidance on treatments and support for these problems.

Some dietary or lifestyle changes may also help. Maintaining a moderate body weight and stopping smoking may reduce the risk of symptom flare-ups and complications from psoriasis.

Rupioid psoriasis is a rare form of plaque psoriasis that causes raised plaques with a cone-like shape. The symptoms can be painful and itchy. Doctors may prescribe systemic treatments, such as methotrexate, for flare-ups.

Long-term management of the condition involves identifying and avoiding triggers, making lifestyle changes, and implementing strategies to cope with any psychological issues. Doctors will prescribe treatments to manage the symptoms and reduce the risk of complications.