Psoriasis in skin folds
Inverse psoriasis can occur in the armpits, groin, under the breasts and in other skin folds around the genitals and buttocks. This type of psoriasis first shows up as smooth, dry lesions that are very red. Inverse psoriasis is frequently irritated by rubbing and sweating due to its location in skin folds and tender areas.
Steroid creams and ointments are considered very effective in treating inverse psoriasis. Because these areas are prone to yeast or fungal infections, doctors sometimes use diluted topical steroids in combination with other medications, such as 1% to 2% hydrocortisone with anti-yeast or antifungal agents.
Elidel and Protopic are also very effective for treating psoriasis in skin folds. They do not support the growth of yeast or fungus.
For a severe episode of inverse psoriasis, try alternating a moderate-strength steroid, such as betamethasone, for a brief period with an antifungal agent, such as Nizoral, in combination with soothing baths.
Topical steroids should be used with caution because skin folds are more susceptible to thinning of the skin. Skin folds also should not be occluded (covered with an airtight plastic or cloth wrap).
Dovonex and Tazorac may also be used in these areas, but be aware that these medications may cause irritation to sensitive skin folds.
Updated October 2005
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