Is Psoriasis Contagious?
No, psoriasis is absolutely not contagious and cannot be transmitted from person to person through any form of contact. 1
Disease Pathophysiology
Psoriasis is a chronic inflammatory autoimmune skin disease, not an infectious condition. 1, 2 The disease mechanism involves:
- Immune-mediated pathogenesis: Inappropriate activation of cutaneous T cells and dendritic cells with subsequent release of inflammatory cytokines, leading to keratinocyte hyperproliferation. 1, 3
- Genetic predisposition: The HLA-Cw6 allele represents the major susceptibility gene, with at least 8 chromosomal loci identified with statistically significant linkage to psoriasis. 3
- Environmental triggers: Factors such as skin trauma, infections, stress, certain medications (lithium, antimalarials, beta-blockers, NSAIDs), and alcohol can precipitate or worsen disease, but the disease itself cannot spread between individuals. 3
Clinical Presentation
Psoriasis classically presents with well-demarcated, erythematous (red) plaques with silvery scale, commonly involving the scalp, elbows, knees, and presacral region. 1, 4 The salmon-colored plaques with white scales on the scalp and elbows are pathognomonic for psoriasis vulgaris. 4
Psychosocial Impact of Misconceptions
The false perception that psoriasis is contagious significantly impacts patients' quality of life. 1 A survey of 215 adult psoriasis patients found that perceptions that psoriasis is contagious (P = .005) were common and correlated inversely with age. 1 This misconception leads to:
- Feelings of alienation, perceived discrimination, and social withdrawal. 1
- Fear of stigmatization, particularly when lesions are visible on hands or cannot be hidden by clothing. 1
- 48% of patients feeling like outcasts due to others' misunderstanding of the disease. 1
Important Clinical Caveat
While psoriasis itself is not contagious, certain infections can trigger or exacerbate psoriasis in genetically predisposed individuals. 5 For example, acute streptococcal infection is frequently associated with guttate psoriasis onset. 5 However, this represents an environmental trigger for disease expression in susceptible individuals, not transmission of psoriasis itself. 3, 5
Patient Education Priority
Healthcare providers should explicitly educate patients, family members, and the public that psoriasis is not contagious and cannot spread through physical contact, sharing items, or any other means of transmission. 6, 7 This education is critical to reducing stigma and improving patients' psychosocial well-being. 1