Not Just Spots: How Not to Miss Psoriasis

28. Oktober 2025

2 Min. Lesezeit

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Psoriasis can easily be confused with dermatitis, rosacea, shingles and other similar diseases. How can you recognize it and take timely action?

Wichtigste Erkenntnisse

Psoriasis can easily be confused with dermatitis, rosacea, shingles and other similar diseases.
The first signals
Psoriasis vs. seborrheic dermatitis

Für wen das ist

Für alle, die Haut, Nägel, Haare über psoriasis, haut erkunden.

Warum es wichtig ist

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Artikelautor

Dr. Mary

Dermatovenerologe

The first signals

Psoriasis can manifest itself at any age, but it most often affects people 16-40 years old. Generally, the disease begins in childhood or adolescence if there is a genetic predisposition to it. Each type of psoriasis has its own characteristic symptoms.

Plaque psoriasis is the most common, affecting about 80-90 % of people who suffer from psoriasis. It is accompanied by plaques (dry, itchy, or raised areas of skin covered with scales). Rashes usually appear on the elbows, knees, lower back, and scalp.

Nail psoriasis occurs when there is abnormal nail growth, the nail plate splits, spots or potholes form on the surface of the nail, and the plate turns yellow, brown, or white. Nails may crumble and separate from the nail bed.

Drop-shaped psoriasis affects adolescents and children more often than older adults. It usually starts with an upper respiratory tract infection, such as acute pharyngitis. Tiny red bumps appear and cover the legs, arms and trunk, and sometimes the face, ears and scalp.

Inversion psoriasis begins with small, blurry patches of dark red discoloration in skin folds in the groin, buttocks, and chest. The condition of the areas of inflamed skin worsens with friction and sweating. This type of psoriasis can be provoked by fungal infections.

Pustular psoriasis arises against a background of stress, infections, medication or contact with chemicals. It begins with dry, inflamed, red skin and is followed by well-defined, pus-filled blisters, usually on the feet and hands. Once dry, brown dots and skin scales may form in their place.

Erythrodermic psoriasis is the rarest type. The body is covered with a flaky rash, and the skin itches and looks burned. This type is characterized by fever, chills, muscle weakness, and palpitations.

Psoriasis vs. seborrheic dermatitis

Because of the similarity of symptoms, psoriasis is often confused with seborrheic dermatitis. In order to distinguish the diseases from each other, you need to look closely. Psoriasis begins with rough, red, flaky skin, followed by thick, usually silver-colored scales over these patches. Spots often occur on the scalp, trunk, limbs, hands, and feet.

The spots in seborrheic dermatitis tend to vary in color‒they can be whitish-yellow, red, or brown. In addition to color, the affected areas are prone to greasiness. This form of dermatitis most commonly affects the scalp and oily areas of the face (such as the creases around the nose or in the ear and eyebrow area), as well as the upper chest and back.

Psoriasis and dermatitis are not contagious, but can be passed on genetically.

Final verdict

At the first suspicion of psoriasis you should see a dermatologist, because the earlier the diagnosis is made the more effective the treatment will be. Generally, an experienced specialist can determine the cause of spots on the skin after visual inspection. However, to clarify the diagnosis it may be necessary to have a dermatoscopy as well as clinical and biochemical blood tests to detect inflammatory, autoimmune or rheumatic processes in the body and endocrine disorders.

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