Britney Spears on X Factor set with Demi Lovato and Simon Cowell.

Britney Spears is showing another devastating sign that her stress level may be off the scale. She was spotted with a nasty psoriasis outbreak on her ankles while she posed for photos at an “X Factor” after party in Los Angeles.

Spears reportedly has been a nervous wreck behind-the-scenes on the musical reality show, where she serves as a judge with Demi Lovato, music mogul L.A. Reid and show creator Simon Cowell.

Psoriasis is genetically related autoimmune disease. Although it’s origin is unknown, it usually flares when an individual is feeling overly stressed or anxious. Those conditions pull down a body’s immune system, triggering an outbreak.

A particularly troubling photo of Spears emerged in May showing that she had also chewed her fingernails down to stubs, causing them to bleed.

The latest development raises the question whether it’s healthy for her to continue on the show. She’s reportedly being paid a whopping $15 million for the season, but it can’t be about the money, unless she’s not calling the shots.

Her finances and personal life are tightly controlled by her father Jamie Spears and her fiance and former agent, Jason Trawick. A court in August refused to lift the conservatorship even over her personal life, although she’s now 31.

A worst-cast scenario would be one where her father pressured her into doing the show. Spears has been visibly uncomfortable serving as a judge and hates to say anything negative about a contestant. Critics say she looks stiff and adds little to the discussion on the show.

“Britney was in Demi’s dressing room, crying her eyes out because she’s cracking under the strain of producers constantly coaching her on how to be more outgoing, talkative and constructive on-camera,” a witness told The National Enquirer’s Mike Walker.

Spears reportedly constantly picks and scratch at the itchy, and sometimes painful sores. Here’s to hoping she can keep it together.