Psoriasis

Psoriasis can affect anyone, regardless of age, gender, or skin tone, but it is more commonly diagnosed in adults than children. It usually first appears between the ages of 15 and 35, though some people may develop it earlier or later in life. Men and women are affected at similar rates.

While psoriasis occurs in all racial and ethnic groups, research suggests it may be slightly more common in individuals with fair skin. However, psoriasis may be underdiagnosed or misdiagnosed in people with darker skin, where the condition can appear more violet, dark brown, or gray rather than red.

Family history plays a strong role in psoriasis. If a parent, sibling, or grandparent has psoriasis, there is a greater chance that another family member will develop it. Other risk factors include stress, obesity, smoking, infections (such as strep throat), certain medications, and cold, dry weather, which can trigger flare-ups in those who are already predisposed to the condition.

Psoriasis is fairly common. In the United States, more than 7.5 million adults are estimated to have psoriasis, according to the National Psoriasis Foundation. It affects about 2 to 3 percent of the global population. Although it is not considered a life-threatening disease, psoriasis can significantly affect quality of life. For some people, the physical discomfort and visible appearance of lesions can lead to emotional distress, including anxiety, embarrassment, and depression.

The most recognizable symptom of psoriasis is the appearance of raised, red, scaly patches of skin, typically covered with a layer of silvery-white buildup. These patches, or plaques, are often itchy, dry, and sometimes painful. They can crack and bleed in more severe cases.

Psoriasis can show up almost anywhere on the body but is most often found on the elbows, knees, scalp, lower back, and trunk. In some people, the plaques are small and isolated; in others, they may cover large areas of the body.

Other common symptoms include:

• Itching or burning in affected areas
• Thickened, pitted, or ridged nails (a sign of nail psoriasis)
• Dry, cracked skin that may bleed
• Joint pain, stiffness, and swelling if psoriatic arthritis is present

Psoriasis varies in severity. Some people experience mild symptoms with just a few patches, while others have more widespread plaques that can interfere with everyday life. The condition can also change over time. Someone with mild psoriasis today may have a more severe flare in the future if triggered by stress, illness, or other factors.

There are several different forms of psoriasis. The most common type is plaque psoriasis, which is raised, red, scaly patches of skin, typically covered with a layer of silvery-white buildup. Plaque psoriasis accounts for about 80 to 90 percent of cases. Other types include:

• Guttate psoriasis: usually appears as small, drop-shaped spots, often after a bacterial infection
• Inverse psoriasis: affects skin folds, such as under the arms or breasts, and tends to be smooth and shiny
• Pustular psoriasis: marked by white blisters filled with pus, surrounded by red skin
• Erythrodermic psoriasis: a rare and severe form that causes widespread redness, shedding, and intense discomfort

Diagnosis typically begins with a physical exam. Dr. Newsome will look closely at the skin, scalp, and nails, paying attention to the size, shape, and distribution of the plaques. In most cases, this visual assessment is enough to identify psoriasis.

To confirm the diagnosis, a doctor may take a small sample of skin—a biopsy—for examination under a microscope. This helps rule out other skin conditions that can look similar to psoriasis, such as eczema, fungal infections, or lichen planus.

There is no specific blood test to diagnose psoriasis. However, if joint pain is present, additional tests such as blood work or imaging (like X-rays) may be ordered to check for psoriatic arthritis.

She may also ask about a patient’s medical history, including family history of psoriasis, lifestyle factors, current medications, and any recent infections or illnesses that could have triggered a flare-up.

Although there is no cure for psoriasis, many people manage their symptoms with treatment and healthy lifestyle choices. Triggers vary from person to person, so learning what causes a flare—whether it’s stress, dry weather, illness, or certain foods—can help keep symptoms under control. Moisturizing daily, avoiding harsh soaps, managing stress, and working with a dermatologist are key parts of long-term psoriasis care.