Almirall
Psoriasis

Psoriasis diagnosis

How is psoriasis diagnosed?

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Psoriasis is usually diagnosed by examining the affected skin. In most cases, a doctor can recognize it during a physical examination. However, because psoriasis can look similar to other skin diseases, sometimes a small sample of skin, called a biopsy, is taken and examined under a microscope.

To support the diagnosis, the doctor will ask about your family history, such as whether anyone in your family has psoriasis.

It is also important to tell the doctor if you have back pain, joint pain, or stiffness, as these symptoms may be related to psoriatic arthritis. 

How is the severity of psoriasis assessed?

The doctor will examine the skin throughout the entire body to confirm that the spots are psoriasis and to measure how severe it is. This includes looking at redness, scaling, itching, location, and how much of your skin is affected. These factors are usually combined into scoring systems such as PASI (Psoriasis Area and Severity Index) and BSA (Body Surface Area).

The doctor will also ask about how psoriasis affects your daily life, including your physical and emotional well-being and social relationships. This is assessed through different  quality-of-life questionnaires.

 

Based on these findings, psoriasis can be classified as mild, moderate or severe. Your doctor needs to ascertain the grade and type of your psoriasis to determine what the best medical treatment for your condition is, and to evaluate how psoriasis responds to such treatment over time.

In addition to these measures, the International Psoriasis Council has proposed a practical framework that defines moderate-to-severe psoriasis not only by BSA thresholds but also by involvement of high-impact areas (such as the scalp, face, palms, soles or genitals) and failure to respond adequately to topical therapies. This approach emphasizes the clinical effect of anatomical site involvement and treatment responsiveness, promoting a more individualized, patient-centred strategy for disease classification and management. 

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