Psoriasis is a common skin condition that often presents with characteristic signs, but only a clinician can give a definite diagnosis. Here’s what to look for and what to do next. What to look for
- Red, raised patches on the skin (plaques) that are dry and covered with silvery-white scales. These patches are most common on the elbows, knees, scalp, and trunk, but can appear anywhere.
- Itchiness, stinging, or soreness in the affected areas. The skin may crack or bleed if scratched vigorously.
- Nail changes such as pitting, thickening, discoloration, or separation of the nail from the nail bed (onycholysis). Joint pain or swelling can indicate psoriatic arthritis, which accompanies psoriasis in some people.
- Possible scalp symptoms like dandruff-like flaking that is persistent or patchy, sometimes with itching.
When to seek medical evaluation
- If you notice well-defined red patches with silvery scales on large areas of your body, or patches that are spreading quickly.
- If you have persistent itching, pain, or thickened nails, or joint symptoms (stiffness, swelling, or pain in joints).
- If you’re unsure whether your skin changes are psoriasis or another condition such as eczema or a fungal infection. A clinician can distinguish between them and discuss appropriate treatment.
How a clinician diagnoses psoriasis
- Medical history and physical examination of the skin, scalp, nails, and joints.
- Sometimes a skin biopsy (a small sample examined under a microscope) to confirm the diagnosis or rule out other conditions.
General management overview
- Treatments vary by type and severity and may include topical corticosteroids, vitamin D analogues, phototherapy, and systemic medications for more extensive disease or psoriatic arthritis.
- Lifestyle and skin care measures can help manage symptoms, such as regular moisturizing, avoiding skin Trauma (the Koebner phenomenon), and identifying potential triggers (stress, infections, medications).
What you can do now
- Painlessly observe any skin changes: note location, pattern, how long they’ve been present, whether they itch or hurt, and if nails or joints are affected. This information helps a clinician assess risk and prioritize evaluation.
- Consider scheduling an appointment with a primary care clinician or a dermatologist if symptoms are persistent, spreading, or affecting quality of life. They can confirm whether it’s psoriasis and discuss personalized treatment options.
If you’d like, I can help you compare psoriasis with common alternatives (eczema, fungal infections) based on your symptoms, or help you prepare questions for a healthcare visit.
