Psoriasis Symptoms & Diagnosis

General appearance | Initial symptoms | Seeing a doctor | Diagnosis of psoriasis

A patient with psoriasis may display symptoms ranging from very mild to severe large-scale eruptions over large areas. When symptoms are mild and in remission, patients can lead a near-normal life. But when there is a flare-up, it can be quite painful as in the case of psoriatic arthritis.  Inflamed plaques can look disfiguring and make patients feel self-conscious and scared.  Severe symptoms appear cyclically, remission periods varying from patient to patient.

General appearance

Psoriasis lesions or plaques seem covered in silvery white-coloured scales with an underlying red/pink centre. They can be in varying sizes and shapes. All lesions have a marked edge around them. In remission, there may be just one or two plaques but during flare-ups, large areas can be covered with the lesions. On scalps, only shiny white flakes may be visible whereas in areas where skin overlaps, pink-red lesions can be seen.

Initial symptoms

Symptoms and signs differ from patient to patient even as the severity of disease fluctuates with time. Generally psoriasis patients exhibit one or more of these symptoms –

• Pink-red skin patches with shiny white scales.
• Dry looking cracked skin which sometimes bleeds.
• Drop like spotty lesions (in children).
• Burning and itching sensation.
• Thick nails with pitting or ridging.
• Stiff and inflamed/swollen joints.
• Pus-filled blisters.

Seeing a doctor

A patch of small red spots that look red or with silvery white scales on them can be the first manifestation of psoriasis. There may be accompanying itching of soreness. Most patients notice only when white scales become profuse and start bleeding. Swollen and stiff joints precede psoriatic arthritis. Going to the doctor in early stages is highly advantageous for quick relief of severe conditions; especially to minimize joint damage in psoriatic arthritis.

Diagnosis of psoriasis

When doctor finds scaly patches, he will

• Inquire about recent illness, new medication or any new stress factors.
• Examine skin, scalp and nails for psoriasis symptoms.
• Ask about family history of psoriasis occurrence.
• Sometimes take skin sample for microscopic study.
• Check for any inflamed or stiff joints.
• If sore throat is a trigger, he may take a throat swab for strep infection check-up.

Each type of psoriasis has different symptoms and based on the symptoms and signs, your dermatologist will decide on the type of psoriasis you are having and chart out a treatment plan.