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.
Plaques can occur on the scalp and penis or on any body surface.
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.
Psoriasis may occur only on the palms and soles. This form of psoriasis can look exactly like hand eczema.
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.
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.