The classic lesion is a red scaling plaque with a well defined border. This is referred to as chronic plaque psoriasis. The scale is described as silvery and reveals pinpoint bleeding when removed.


Plaque psoriasis with silvery scale on the surface


Wide spread plaque psoriasis


Psoriasis of the palms and soles may look just like hand eczema

Plaques can occur on the scalp and penis or on any body surface.


Psoriasis commonly occurs on the scalp


Psoriasis of the penis may be the only indication that the patient has psoriasis

Plaques increased areas such as under the arms the breasts the groin and around the anal area are red but contained no scale. Redness about the anal area is called gluteal pinking and is a classic sign of psoriasis.


Gluttial pinking of the anal area is a classic sign of psoriasis


Psoriasis that appears in skin folds does not form scale on the surface. It is often misdiagnosed as a yeast infection.

Psoriasis may occur only on the palms and soles. This form of psoriasis can look exactly like hand eczema.

Pustular psoriasis of the palms and soles

Pustular psoriasis of the palms and soles

Some patients have wide areas of just redness. Others may present with a rare form of the disease called pustular psoriasis. These latter forms of the disease can be serious and require immediate treatment with potent drugs such as methotrexate or cyclosporine.


Patients with wide spread redness have erythrodermic psoriasis


The nails may also be affected. The nails should always be examined in patient’s who are suspected of having psoriasis. He presents of classic nail changes can help establish the diagnosis in difficult cases. Pitting of the nails and separation of the nail from the nailbed at the tip of the finger are common signs. Some patients with psoriasis will present with only nail changes. There is no effective topical treatment for nail disease.


Nail pitting is a highly characteristic sign of psoriasis


Separation of the nail plate at the tip of the fingers is another common presentation of nail psoriasis