Psoriasis is a chronic condition that causes itchy plaques to develop on the skin. It can develop anywhere, including the chest. Depending on skin tone, psoriasis on the chest may be red, violet, or brown.

Psoriasis is an immune-mediated disease that causes skin cells to grow too quickly. This rapid growth means shedding is ineffective, and the skin cells pile up on each other, causing plaques and scales.

While its most visible symptoms affect the skin, it is a systemic condition, meaning it can affect the whole body.

This article explores psoriasis on the chest, including types and symptoms. It also looks at diagnosis and treatment.

Psoriasis can look different depending on the type a person has, as well as their skin tone.

Some of the symptoms include:

  • patches of raised, thickened skin that may be red, violet, or darker than the person’s skin tone
  • silvery scales or flakiness
  • itchiness, burning, or stinging
  • cracked, dry skin that bleeds
  • blisters or pustules
  • thick, ridged nails

While white people with psoriasis typically experience red, scaly plaques, people with darker skin tones usually experience violet, darker brown, or gray patches.

Psoriasis symptoms tend to flare up and then calm down. People with the condition may have times when symptoms worsen and then get better.

There are various types of psoriasis that may affect the chest, including:

Guttate psoriasis

This is the type of psoriasis most likely to appear on the chest, developing as small, round, red spots that result from inflammation. Guttate psoriasis affects about 8% of people with the condition.

Chronic plaque psoriasis

Plaque psoriasis is the most common type and affects up to 80% of those with the condition. The plaques can appear anywhere on the body, including the chest. They present as raised, inflamed patches of skin, which may be red or violet with silvery scales, and they can be itchy and painful.

Inverse psoriasis

This type of psoriasis affects about 25% of people, and most commonly develops in the folds of skin, in areas such as under the breasts, the genital area, and the underarms.

While it does not cause scales or plaques, it can be painful and itchy.

Pustular psoriasis

This type affects about 3% of people with psoriasis. Symptoms include inflamed skin and white, pus-filled, painful bumps. It may cover most of the body or appear on certain areas such as the feet and hands.

Erythrodermic psoriasis

This type of psoriasis is rare, affecting around 2% of people with the condition. It is severe and can cause intense shedding of skin, which comes off in large sheets.

It can affect the entire body and can be life threatening. Other symptoms include changes in temperature and heart rate, severe pain and itching, and dehydration.

Doctors do not fully understand what triggers psoriasis, but it has several associations, including:

Family history

A person has a higher risk of developing psoriasis if they have a parent, grandparent, or sibling with psoriasis.

Immune system

When a person has psoriasis, their white blood cells malfunction. White blood cells usually attack viruses and bacteria, but the condition causes them to attack the skin, causing the body to make more new skin cells faster than usual. The extra skin cells pile up on the surface of the skin.

Once this condition starts, it usually continues for the rest of a person’s life, becoming chronic.

Triggers

Common triggers for psoriasis include:

A dermatologist will diagnose psoriasis by examining a person’s scalp, nails, and skin for signs of the condition. They will ask for any symptoms of the condition, including itchy skin, joint problems, or a family history of psoriasis.

Sometimes, a dermatologist may perform a biopsy by removing a piece of the skin. By examining this sample, they can confirm whether or not a person has psoriasis.

Diagnosing people of color

Psoriasis presents differently on different skin colors. Because of this, and a lack of awareness about the differences, psoriasis may go misdiagnosed and undiagnosed more frequently among people of color.

Additionally, although psoriasis is more common in white people, the condition affects people of color more severely. With this in mind, doctors need to be aware of how psoriasis looks in different skin tones.

If a person thinks they may have psoriasis that a doctor has overlooked, it may help to get a second opinion or seek advice from a dermatologist with experience treating a variety of people.

A dermatologist will treat psoriasis according to the severity of the condition and its location on the body.

For psoriasis on the chest, a person may receive topical medication to apply directly to the skin, oral medications that work throughout the body, or light therapy.

The medications may include corticosteroids, synthetic vitamin D, retinoids, and coal tar. Light therapy, or phototherapy, involves a doctor or dermatologist shining UV light onto the skin.

A person can also try an anti-inflammatory diet, such as the Mediterranean diet, which may help improve psoriasis. The Mediterranean diet focuses on:

  • fiber
  • nuts and seeds
  • oily fish
  • vegetables
  • fruits
  • beans

Psoriasis is often associated with or mistaken for other conditions. These include:

  • Eczema: Doctors sometimes misdiagnose psoriasis as eczema. In some cases, individuals develop both, so there can be some overlap of conditions.
  • Ringworm: This is a fungal infection called tinea or dermatophytosis. People call it ringworm because it causes an itchy, ring-shaped rash.
  • Pityriasis rosea: This condition causes a rash that often starts as a large oval patch on the skin, followed by smaller patches or small bumps. The rash can appear anywhere on the skin and is common on the chest, stomach, and back. It may accompany flu-like symptoms and itching.
  • Shingles: This painful rash can occur in people who have previously had chickenpox. It generally appears on only one side of the body or face. It develops into blisters that usually scab over within 7 to 10 days and clear up in 2 to 4 weeks.

People with psoriasis are more likely to have some other disorders, including:

Psoriasis is a chronic immune disorder that triggers inflammation. It can occur anywhere on the body, including the chest.

Different types of psoriasis include plaque, guttate, inverse, pustular, and erythrodermic, while symptoms include patchy, dry, cracked, and scaly skin.

Psoriasis may be due to genetics, the immune system, and certain triggers, such as dry weather. Treatment may include medication, phototherapy, or dietary changes.