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Psoriasis Diagnosis

Psoriasis Diagnosis
With any disease, an accurate diagnosis is the first step in ensuring proper treatment. A doctor makes the psoriasis diagnosis after s/he has asked a series of questions and carefully examined your skin. In most cases, the physical examination of your skin alone is enough to make the diagnosis. There are a few things doctors will ask when making a diagnosis:


  • Is there a family history of psoriasis?
  • How long have you had this condition?
  • What treatments have you received?
  • How effective were they?
  • Do you have tender and/or swollen joints
        (arthritis)?
  • Are your fingernails/toenails affected?
  • Do you have a history of skin lesions
        improving in summer and worsening in
        winter?
  • Do you have one or more raised, red,
        silvery, scaling areas?
  • Is the disease in the classic locations with
        symmetrical involvement of the elbows,
        knees, lower back, scalp, finger and/or
        toenails (rough, discolored appearance,
        often with individual pits in the nail plate)?
    • Psoriasis Diagnosis

    There are multiple types of psoriasis, and your doctor will examine you to see which type you have. Also, your doctor might want to see if other body areas are involved, such as the joints.

    How Is Psoriasis Diagnosed? Psoriasis Diagnosis

    Your doctor will analyze your skin, nails and scalp in search of signs of psoriasis. The nails show changes in about 50 percent of all cases. There could be pitting, which looks like pinholes in the nail, and/or the nails can be yellowish or thickened.

    If there is still doubt whether psoriasis is present or not, the doctor could :

  • perform a biopsy of the skin
  • request X-rays, especially when joint pain is apparent
  • take blood tests

    •

    Let's take a look at these options in more detail.


    Biopsy

    A skin biopsy is used only in those instances where it is difficult to diagnose the disease. This relatively painless procedure involves numbing a small area of skin with a local anesthetic. A special instrument called a "punch biopsy" is then rotated on the skin and light pressure applied, removing about a 3-4 mm piece of skin for testing. Following this procedure, one or two sutures might be used to "stitch" the skin, and a bandage applied.

    The skin sample is then examined under a microscope. A pathologist—a doctor specially trained to examine skin tissue under a microscope—will assist in examining the sample. Certain characteristics of the analyzed skin will help pathologists determine if psoriasis is the underlying cause.

    X-rays

    Where there is joint swelling or signs of joint deformity, X-rays can reveal characteristic damage to the joints. If there are signs of arthritis, the family doctor or dermatologist could request a rheumatologist—a specialist in arthritis—to examine the joints and assess the condition further.

    Blood Tests

    Blood tests may be performed if you have arthritis. A blood test called rheumatoid factor is commonly done to exclude rheumatoid arthritis. Rheumatoid factor is a protein found in the blood of most patients with rheumatoid arthritis. Most patients with psoriatic arthritis test negative for rheumatoid factor.

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