Manhattan Dermatology Specialists
  • MIDTOWN 56 W 45TH ST, STE 819 New York, NY 10036
  • UPPER EAST SIDE 983 PARK AVE, STE 1D1 New York, NY 10028
  • UNION SQUARE 55 W. 17TH ST STE 103 New York, NY 10011

Psoriasis can be difficult to diagnose because it often looks similar to other skin diseases such as rashes, eczema, or fungal infections. Psoriasis is incurable, but there are a number of treatment options that can reduce outbreaks: steroid based creams, retinoids, immunomodulators, light therapy, biologics. 


The Histopathology of Psoriasis

Psoriasis is one of the more misunderstood skin disorders today. It’s a condition where your skin cell’s life cycle changes so that they regenerate much more rapidly. In fact, skin cells multiply 10 times faster with psoriasis. As a result, the cells build up on the surface of your skin. Psoriasis is a chronic skin condition that can last years or for your whole lifetime. It can be consistent over time, or you may experience periodic flare-ups. It’s not contagious and is caused by genetics.

When your Manhattan dermatologist diagnoses your psoriasis, a treatment plan is developed to keep your symptoms to a minimum and reduce the number of flare-ups you’ll have. Psoriasis should always be evaluated with a thorough consultation and examination by a physician for an accurate diagnosis and treatment plan as it may be a symptom or sign of a serious illness or condition.

The Symptoms of Psoriasis

The excess skin cells form thick, scaly, dry, itchy skin that’s often red and painful. These patches are typically found on your knees, elbows, and scalp, but they sometimes appear on your palms, lower back, and soles of your feet. The symptoms of psoriasis vary in severity and location on your body. The most common symptoms of psoriasis include:

  • Red, raised, inflamed skin
  • Silvery, scaly patches
  • Small, red spots
  • Dry skin that cracks and bleeds
  • Burning, itching, and sore skin
  • Pain in your joints or joint stiffness
  • Dents in your nails
  • Fingernails or toenails separating from the nail bed
  • Thick patches of skin
  • Inflamed tendons

Types of Psoriasis

In general, there are seven different types of psoriasis. Your treatment is determined by the diagnosis from your dermatologist. Each varies in severity and symptoms. The seven types are:

  1. Plaque Psoriasis
  2. Guttate Psoriasis
  3. Inverse Psoriasis
  4. Pustular Psoriasis
  5. Erythrodermic Psoriasis
  6. Nail Psoriasis
  7. Psoriatic Arthritis

Plaque Psoriasis is the most common of all types. In fact, it’s estimated that 80 percent of people have this type of psoriasis to some degree. Dermatologists often refer to it as psoriasis vulgaris. This type of psoriasis presents raised, inflamed skin that’s covered with white or silvery scales. Typically, you see it on your elbows, knees, scalp, or lower back. These patches itch and can even be painful.

Guttate Psoriasis only makes up about two percent of all cases, although most often, this condition affects children. It presents itself as small red spots scattered on your skin, typically on your scalp, thighs, upper arms, or torso. It’s commonly triggered by infections, such as strep throat and certain medications.

Inverse Psoriasis, This form of psoriasis shows itself as areas of red and irritated skin growth without the silvery, scaled top layer. The typical regions on your body where inverse psoriasis is found include the skin:

  • Under your breasts
  • In your groin
  • Under your arms
  • Around your genitals and buttocks

This is an uncommon form of psoriasis. It occurs mostly in adults and causes pus-filled bumps similar to pimples but around the dry, irritated skin patches. It can show up in one concentrated area or all over your body. When it’s everywhere, it’s called generalized pustular psoriasis, and if you have it, call your dermatologist immediately. It’s a serious condition. This type of psoriasis can be triggered by medications, sunburn, pregnancy, infections, and stress. Side effects and symptoms of this condition can include:

  • Fever
  • Nausea
  • Chills
  • Weakness
  • Rapid heart rate

Erythrodermic Psoriasis This is the least common form of psoriasis, but like pustular psoriasis, it’s very serious. If you’re experiencing the symptoms below, seek medical attention immediately. Erythrodermic psoriasis affects your whole body and causes your skin to look as though it’s been burned. You may experience:

  • Severe itching or burning
  • Rapid heart rates
  • Changes in body temperature
  • Skin that’s beginning to peel

Things that can trigger erythrodermic psoriasis include suddenly stopping psoriasis treatment, allergic reactions to drugs, serious sunburn, infection, and some medications. It can also be caused by other forms of psoriasis if difficult to control.

Nail Psoriasis About 50 percent of all people with psoriasis of some type of experience bouts with nail psoriasis. Changes to fingernails and toenails are common if you have psoriatic arthritis or a form of psoriasis that affects your joints. Symptoms of nail psoriasis include:

  • Dents in your nails are often called pitting
  • Tender or painful nails
  • Nails that separate from the nail bed are called onycholysis
  • Yellow or brown nails
  • Chalky material under your nails

This is a condition that should be diagnosed by your dermatologist in NYC because it may resemble toenail fungus. The two conditions can look very similar, but a good dermatologist knows how to diagnose them.

Psoriatic Arthritis This is a condition where you have arthritis affecting your joints. It’s a serious and painful condition that requires medical treatment and management. If you’ve had psoriasis for 10 years or more, there is a 70 percent chance you’ll develop psoriatic arthritis. You also have a 90 percent chance of developing nail psoriasis. Common symptoms of psoriatic arthritis include:

  • Stiff joints
  • Painful joints
  • Stiffness and pain that’s worse in the morning
  • Swelling fingers and toes
  • Discolorations of the joints
  • Warm joints

Causes of Psoriasis

Psoriasis is a condition that’s still not completely understood. In many cases, dermatologists in NYC are unsure of what caused the symptoms. For others, the causes are different. Some causes of psoriasis include:

  • Genetics: About eight percent of people with psoriasis report having a family member with the condition.
  • Environmental triggers: These include stress, skin trauma, infections, and medications. Talk to your dermatologist about what triggers your symptoms.
  • Immune system dysfunction: You’re susceptible to many conditions and illnesses, including psoriasis, when your immune system isn’t functioning properly

Diagnosis and Treatment

Psoriasis can be difficult to diagnose because it often looks similar to other skin diseases such as rashes, eczema, or fungal infections.

★ ★ ★ ★ ★Dr. Bard is very knowledgeable and helpful. She was able to identify all the issues right away and recommend treatment.

Psoriasis is incurable at this point in time, but there are a number of treatment options and combinations that can reduce outbreaks and keep the condition from interfering with your day-to-day life. These include:

  • Steroid based creams
  • Coal- tar ointments and shampoos
  • Calcipotriene ointments
  • Topical and oral retinoids
  • Oral immunomodulators
  • Oral antiinflammatories
  • Light therapy
  • Biologics

Psoriasis should always be evaluated with a thorough consultation and examination by a physician for an accurate diagnosis and treatment plan as it may be a symptom or sign of a serious illness or condition.

Important Reminder: This information is only intended to provide guidance, not definitive medical advice. Please consult a dermatologist in NYC about your specific condition. Only a trained, experienced board certified dermatology doctor or pediatric dermatologist could determine an accurate diagnosis and proper treatment.

Do you have any questions about Psoriasis? Would you like to schedule an appointment with an internationally recognized, best-rated dermatologist in Manhattan, NYC, Dr. Susan Bard of Manhattan Dermatology Specialists? Please contact our Midtown or Upper East Side NYC office for a consultation with a cosmetic and laser dermatologist.

Updated on Mar 7, 2023 by Dr. Susan Bard (Dermatologist), Manhattan Dermatology Specialists Locations: Manhattan Dermatology (Upper East Side) 983 Park Ave, Ste 1D1, NY 10028
(212) 427-8750
Manhattan Dermatology (Midtown) 56 W 45th St, Ste 819, NY 10036
(212) 889-2402
Manhattan Dermatology (Union Square) 55 W 17th St, Ste 103, NY 10011
(212) 378-9984
DISCLAIMER: PLEASE READ CAREFULLY The information on this website is to provide general information. The information on this website does NOT reflect definitive medical advice and self diagnoses should not be made based on information obtained online. It is important to consult a physician for a consultation and examination regarding ANY and ALL symptoms or signs you may be having. An accurate diagnosis and treatment plan should only be made by your physician in order to exclude a serious condition.
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