Fast Five Quiz: Presentation and Diagnosis Plaque Psoriasis

Medscape

11-07-2025

Plaque psoriasis is the most common form of psoriasis. Recognition of symptoms and prompt diagnosis are critical to prevent the progression of joint damage and to improve patients' quality of life and long-term physical function.
How much do you know about the presentation and diagnosis of plaque psoriasis? Test your knowledge with this quick quiz.
According to a recent analysis, patients with moderate disease most commonly present with more cracked skin, tender skin, and redness or discoloration than those with mild disease at diagnosis. Conversely, scaling and flaking are less common in patients with moderate psoriasis at diagnosis than in those with mild disease. Although both mild and moderate psoriasis can present with other symptoms such as pruritus, burning, and pain/stiffness in joints, the differences in prevalence are not statistically significant or as distinctive.
Learn more about physical examination for plaque psoriasis.
Guttate psoriasis is normally self-limited, but in some cases, it can progress to chronic plaque psoriasis.
Patients with plaque psoriasis have frequently reported worsening of symptoms in the winter and improvement of symptoms with warmer weather; however, symptoms can worsen at any time, depending on the patient.
Koebner phenomenon refers to the appearance of new lesions at sites of injury or trauma to the skin. It is believed to occur in up to 75% of patients with psoriasis.
Pruritus is a cardinal feature of plaque psoriasis and can occur with any severity of disease.
Learn more about the presentation of plaque psoriasis.
The physical examination of a patient with plaque psoriasis might reveal symmetrical lesions on the scalp, trunk, buttocks, and limbs as well as the extensor surfaces of the knees, elbows, and genitals. In some cases, plaque psoriasis might present as well-demarcated oval-shaped plaques that can range in size.
Widespread erythema covering nearly the entire body with variable amounts of scaling is more likely to be seen with erythrodermic psoriasis, not plaque psoriasis; it is considered a life-threatening emergency, as these patients are at risk for hemodynamic instability.
Drop-shaped, salmon-colored papules with fine scale are more characteristic of guttate psoriasis, not plaque psoriasis.
Learn more about the signs and symptoms of plaque psoriasis.
Psoriatic plaques tend to have a high degree of uniformity with few morphologic differences between the two sides. Fissuring within psoriatic plaques can occur when lesions are present over joint lines or on the palms and soles. They are raised and easily palpable owing to the thickened epidermis, expanded dermal vascular compartment, and infiltrate of neutrophils and lymphocytes that are characteristic of the disease. Further, psoriatic plaques are symmetrically distributed over the body.
Learn more about the signs and symptoms of plaque psoriasis.
According to a review consisting of patient data, Black individuals with psoriasis reported lower amounts of erythema but higher rates of dyspigmentation and more BSA involvement than White individuals. Moreover, other data have indicated that lasting skin dyspigmentation is also among the most frequent complaints in patients with skin of color, and Black individuals might have thicker plaques that appear grayish or purple. Additionally, scalp psoriasis is more commonly seen in Asian and Black individuals than in Western European individuals, and Asian and Hispanic individuals are also more likely to cite stress as an exacerbating factor than White individuals.
Learn more about the nuances of plaque psoriasis presentation.