Signs and Symptoms of Psoriasis

Typically, psoriasis lesions are round, red, and have sharply defined edges with an overlying silvery white scale. These plaques usually begin as small spots that progressively involve very large areas. The scales can be scraped off, resulting in pinpoint bleeding of the lesions.

One form of the condition, guttate (drop-like) psoriasis, appears as a sudden eruption of numerous small, pink, scaly lesions scattered over the body. This variant typically follows a strep infection, such as strep throat.

Pustular psoriasis is a distinct variant that occurs as an eruption of small pustules, or pimples, all over the body. This may be accompanied by fever. The pustules can also appear on the palms, soles, and in the nail beds.

Nail involvement occurs in about 50 percent of psoriasis patients and can manifest as pitting on the surface, as thickening of the nail itself, or as a dissassociation of the nail with the bed. Psoriatic arthritis develops in about 5 percent of psoriasis patients when they are between 30 and 50 years of age. Psoriasis usually precedes the onset of arthritis by several years.

The course of psoriasis generally is prolonged and chronic, with unpredictable flare-ups. Some patients experience spontaneous improvement and resolution.

Potential Problems Associated with Severe Psoriasis

People with severe psoriasis have a shorter life expectancy, says a study published recently in the Archives of Dermatology. The study tracked patients in the UK for 15 years and defined "severe" as needing systemic treatments; however the study was done before medications known as biologics were available.

More research is required to determine if severe psoriasis is a direct cause of reduced life span or if factors associated with the disease—such as smoking, drinking, obesity and social isolation—are the cause.

Psoriasis Diagnosis

Psoriasis can be diagnosed by physical examination. To confirm the diagnosis, a skin biopsy can be obtained and sent for pathological analysis. The distinct features of psoriasis under the microscope usually confirm or exclude the diagnosis.

Publication Review By: Stanley J. Swierzewski, III, M.D.

Published: 31 Aug 2000

Last Modified: 01 Oct 2015