Table of ContentsView AllTable of ContentsDiagnosisConsultationTypesPASI ClassificationDifferential DiagnosesTreatments
Table of ContentsView All
View All
Table of Contents
Diagnosis
Consultation
Types
PASI Classification
Differential Diagnoses
Treatments
To confirm a psoriasis diagnosis, your healthcare provider will check your skin and scalp for thick, red, scaly patches and other rashes. They also look for changes in your fingernails. Your family and medical history are also essential. Issues like whether you had a recent illness, are under stress, or have itchy skin without a rash contribute to an accurate diagnosis well.
If your healthcare provider isn’t certain of your psoriasis diagnosis, they can perform an in-office biopsy, look at a small sample of the rash under a microscope, and verify if you have psoriasis. Seeking an early diagnosis allows you to gettreatmentthat may prevent complications like psoriatic arthritis.
How Psoriasis Is Diagnosed
There are many health conditions that can cause itchy, scaly skin and rashes. In most cases, healthcare practitioners—especiallydermatologists, who specialize in skin disorders—can tell if your symptoms are due to psoriasis or something else based on sight alone.
Your psoriasis exam includes:
Symptom Review
Before your physical exam, your provider will learn about your symptoms. Though a visible rash is the primary symptom, psoriasis is known for causing itching, burning, and pain. Learning about these symptoms helps your provider confirm your diagnosis.
There are several types of psoriasis and some can causesymptomsthat affect more than your skin. Your provider may ask about other symptoms that seem unrelated, such as fatigue, eye inflammation, or a low-grade fever.
Physical Exam
Your physical exam includes:
Skin and scalp exam
Your provider will complete a close-up examination of your skin and scalp, often using a dermatoscope. The dermatoscope is a handheld device that magnifies skin lesions and takes images, allowing your provider to zoom in, assess skin lesions, and identify psoriasis. They evaluate the type of rash (each type of psoriasis has a different type of rash) and its location.
Nail exam
Your provider will examine your nails, looking for thickening or yellowing. They also check for pain and tenderness.
Joint exam
Nearly one-third of people with psoriasis develop inflammatory arthritis. Your provider will assess your joints, looking for swelling, pain, and stiffness.
Skin Biopsy
Rashes can develop for many different reasons. So if your rash doesn’t look like a typical psoriasis rash, your dermatologist may proceed with a skin biopsy.They will likely get the tissue sample via apunch biopsy.
This procedure is done in the doctor’s office with alocal anestheticto numb the skin. A tube-shaped device that snaps down when pressed (similar to a paper hole puncher) removes a tiny piece of skin.
The tissue sample is stained with a blue dye calledhematoxylin-eosin. This helps the skin cells stand out when your provider views the biopsy under the microscope. With psoriasis, the skin cells appear dense and compact (acanthotic).
If the physical exam left any questions about your diagnosis, a skin biopsy will confirm if you have psoriasis.
Preparing For Your Consultation
In preparation for your visit, it can help to write down when you have flares, how long they last, what symptoms you have, and if anything seems to make them better or worse. Take note of any treatments or illnesses that took place around the time of your flares as well.
In addition, they will likely ask you if you have any other risk factors for psoriasis, such as:
Psoriasis Doctor Discussion GuideGet our printable guide for your next doctor’s appointment to help you ask the right questions.Download PDFEmail AddressSign UpThank you, {{form.email}}, for signing up.There was an error. Please try again.
Get our printable guide for your next doctor’s appointment to help you ask the right questions.
Download PDF
Email AddressSign UpThank you, {{form.email}}, for signing up.There was an error. Please try again.
Sign Up
Thank you, {{form.email}}, for signing up.
There was an error. Please try again.
Types of Psoriasis
Your healthcare may diagnose one of the followingtypes of psoriasis:
Plaque Psoriasis
Plaquepsoriasisaffects up to 80% of people with psoriasis, making it the most common type.It causes patches of red, dry skin covered with silvery-white scales. Theseskin plaquescan appear anywhere on your body but often affect the scalp, knees, elbows, and lower back.
Guttate Psoriasis
Guttate psoriasis, the second most common type, affects children and young adults.Its telltale sign is a pale, red, teardrop-shaped patch, typically on the arms, legs, or body. It often develops after a bacterial or viral infection, likestrep throatorchickenpox.
Inverse Psoriasis
Inverse psoriasis causes inflamed, red, or darkened skin that’s smooth (instead of scaly). This type most often develops in skin folds like your underarms, under breasts, and buttocks.
Pustular Psoriasis
Pustular psoriasis affects about 3% of people diagnosed with psoriasis.It causes pus-filled, painful bumps (pustules). The pustules may stay on your hands and feet or cover most of your body.
Erythrodermic Psoriasis
This is a rare type of psoriasis causing intense redness and skin shedding. It affects nearly the entire body and can be life threatening.
If your doctor finds that you have psoriasis, they may classify your condition’s severity using the Psoriasis Area and Severity Index (PASI).The index grades your condition based on how severe your symptoms are.
Symptoms on your head, arms, trunk, and legs are all assessed visually. No special tools or tests are needed.
Each symptom on each of these body parts is given a value. The values are then added up to get a final PASI score. The higher the value, the more severe your condition.
The PASI reference values are as follows:
By determining the PASI score at diagnosis and repeating the PASI every few months, your dermatologist can track your response to treatment.
Many skin and health conditions cause symptoms that look like psoriasis. There is always a chance you could be diagnosed with a different condition at first, such as a drug allergy or a fungal infection, only to later be diagnosed with psoriasis.
On the other hand, it’s also possible for psoriasis to be suspected when it’s actually another condition that’s causing your symptoms.
Some of these are serious, so your doctor may want to do a few tests to rule them out before confirming your diagnosis. This process is known as adifferential diagnosis(DDx).
Conditions that can mimic psoriasis include:
Does Psoriasis Have Stages?Tiny bumps are often the earliest sign of psoriasis. As the bumps grow, they develop scales. However, each person has a different experience.Your first flare-up may be mild or severe. Psoriasis may stay the same or keep getting worse but it doesn’t go through specific stages.
Does Psoriasis Have Stages?
Tiny bumps are often the earliest sign of psoriasis. As the bumps grow, they develop scales. However, each person has a different experience.Your first flare-up may be mild or severe. Psoriasis may stay the same or keep getting worse but it doesn’t go through specific stages.
Tiny bumps are often the earliest sign of psoriasis. As the bumps grow, they develop scales. However, each person has a different experience.
Your first flare-up may be mild or severe. Psoriasis may stay the same or keep getting worse but it doesn’t go through specific stages.
The primary treatments for psoriasis include topical, oral, and injected medications and phototherapy:
Medications
Topical medications help to ease itching, reduce inflammation, slow skin growth, remove scaly skin, and keep your skin hydrated.
Today’s advanced biologic medications are given through an intravenous (IV) infusion or injection. These drugs precisely target specific immune activities. For example, they may stop the production of inflammation-causing substances or make the immune system destroy the antibodies causing psoriasis.
Phototherapy (Light Therapy)
Searching for a CurePsoriasis is a chronic autoimmune disease that begins when the immune system mistakenly triggers inflammation and causes unusually rapid skin cell growth. There’s currently no cure for this challenging condition.However, research is ongoing and medical experts continuously develop new medications as they search for a cure. The treatments available today can put your symptoms into remission for months or years.
Searching for a Cure
Psoriasis is a chronic autoimmune disease that begins when the immune system mistakenly triggers inflammation and causes unusually rapid skin cell growth. There’s currently no cure for this challenging condition.However, research is ongoing and medical experts continuously develop new medications as they search for a cure. The treatments available today can put your symptoms into remission for months or years.
Psoriasis is a chronic autoimmune disease that begins when the immune system mistakenly triggers inflammation and causes unusually rapid skin cell growth. There’s currently no cure for this challenging condition.
However, research is ongoing and medical experts continuously develop new medications as they search for a cure. The treatments available today can put your symptoms into remission for months or years.
Summary
Many medical conditions cause skin symptoms that can look and feel like psoriasis. Some of them can be serious, which is why it’s important to have your doctor check out any changes in your skin.
9 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Felix PAO, Sampaio AL, Silva BL, et al.Early intervention in psoriasis: Where do we go from here?Front Med (Lausanne). 2022Dec 1;9:1027347. doi:10.3389/fmed.2022.1027347.
American Academy of Dermatology.Psoriasis: Diagnosis and treatment.
National Psoriasis Foundation.Locations and types.
National Psoriasis Foundation.Plaque psoriasis.
Kim WB, Jerome D, Yeung J.Diagnosis and management of psoriasis.Can Fam Physician. 2017;63(4):278-285.
Lee HJ, Kim M.Challenges and Future Trends in the Treatment of Psoriasis.Int J Mol Sci. 2023 Aug 28;24(17):13313. doi:10.3390/ijms241713313.
Mount Sinai.Psoriasis.
American Academy of Dermatology.Psoriasis treatment: phototherapy.
Brandon A, Mufti A, Sibbald G.Diagnosis and management of cutaneous psoriasis: A review.Skin Wound Care. 2019;32(2):58-69. doi:10.1097/01.ASW.0000550592.08674.43Weigle N, McBanem S.Psoriasis.Am Fam Physician. 2013;87(9):626-33.
Brandon A, Mufti A, Sibbald G.Diagnosis and management of cutaneous psoriasis: A review.Skin Wound Care. 2019;32(2):58-69. doi:10.1097/01.ASW.0000550592.08674.43
Weigle N, McBanem S.Psoriasis.Am Fam Physician. 2013;87(9):626-33.
Meet Our Medical Expert Board
Share Feedback
Was this page helpful?Thanks for your feedback!What is your feedback?OtherHelpfulReport an ErrorSubmit
Was this page helpful?
Thanks for your feedback!
What is your feedback?OtherHelpfulReport an ErrorSubmit
What is your feedback?
