Toronto Psoriasis Centre
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How is psoriasis diagnosed?

Dermatologists diagnose psoriasis by taking a thorough history and examining the skin, nails, and scalp. If the diagnosis is in doubt, a skin biopsy may be helpful.

There are different degrees and ratings for severity based on various factors such as redness, thickness of plaques, and scaling, as well as which body locations are affected and what overall body surface area is involved. Scoring or ratings are used for various purposes by dermatologists, including for clinical research trials, to follow patient progress and improvement, and for insurance purposes (drug coverage).

Living with psoriasis

Related conditions

Unfortunately other conditions are known to co-exist or be more common in patient with psoriasis, many of which are linked to chronic inflammation in the body. You may never develop any of these tag-along conditions, but fortunately if you do, there are treatments available for all of them.

People with psoriasis can develop cardiovascular disease, which is a disease of the heart and blood vessels. This can increase your chances of having a heart attack. It is also possible to develop “metabolic syndrome”, which is a term used to describe a group of symptoms that occur at the same time and are genetically associated with psoriasis.

These symptoms include: obesity, high cholesterol, high blood pressure, high insulin levels and diabetes, all of which are bad for the heart.

Because the skin and intestines share similar inflammatory and immune responses, celiac disease, Crohn’s disease and ulcerative colitis are more commonly found in people with psoriasis.


Approximately 20-30% of people with psoriasis have or may develop psoriatic arthritis because, as with inflammatory bowel disease, these two conditions share a similar inflammatory response.

The most common scenario would be the development of psoriatic arthritis after having psoriasis for 10 or more years.

Inflammation can occur in many or just a few joints. The most common location for psoriatic arthritis is in the hands, wrists, neck, back, knees, ankles and or feet. It can lead to deformity and sometimes to inflammation of the tendons and ligaments. People with symptoms of arthritis should speak with their dermatologist and/or consider seeing a rheumatologist.

Psoriasis can be much more than just a physical condition. It can greatly affect your emotions and lead to depression, self-consciousness, embarrassment and anxiety. These feelings are understandable since psoriasis can present individuals with many challenges, physically, socially and financially.

Recently, medical studies have found a link between inflammation and a person’s mood. Inflammatory chemicals that are released in a person with psoriasis can travel to the central nervous system and cause depression, fatigue, poor sleep and impair clear thinking.

It is extremely important to talk to your doctor about any other symptoms you may be experiencing other than your psoriasis as it can affect the type of treatment they choose for you.

Healthy lifestyle

Currently, diet is believed to only have a small impact on psoriasis. However, a well balance diet may help to protect your joints from psoriatic arthritis. In general, overweight people tend to respond better to therapy if they lose weight. If you are currently taking any supplements, please advise your doctor as it can affect they type of treatment they choose for you.

Consider adding more vegetarian meals to your diet, and more fish like salmon. Smoking and excessive alcohol consumption can sometimes cause a person’s psoriasis to flare up and become worse as well as possibly cause other physical and social ramifications.

It can be difficult to undo these habits that have developed over a lifetime but try to stop and become as healthy as you can. In a small percentage of psoriasis patients, avoiding gluten may also be helpful in reducing psoriasis symptoms and severity.


People with psoriasis generally have dry, itchy and/or irritable skin, so it is important in the winter time to humidify the air, to wear breathable non-irritating fabrics like cotton (& avoid wool), and to moisturize with creams following bathing.