Which description best describes psoriasis vulgaris lesions?

Which description best describes psoriasis vulgaris lesions?

• A. They are small patches with minimal scaling
• B. They are typically raised with thick silvery scales
• C. They appear as flat patches with no scaling
• D. They are vesicular lesions

Answer: (B)

Psoriasis vulgaris shows raised, well-demarcated plaques that are covered with thick, silvery scales. This hallmark comes from accelerated skin cell turnover leading to epidermal hyperplasia and parakeratosis, so the plaques are elevated and surrounded by red, inflamed skin with flaky, adherent scales. On exam, you’ll often see these plaques on extensor surfaces such as the elbows and knees, and on the scalp. The other descriptions don’t fit because they describe conditions with little or no scale, flat non-scaly patches, or vesicles, which are more characteristic of pityriasis alba or tinea versicolor (small patches with minimal scaling), vitiligo or certain hypopigmented conditions (flat patches with no scaling), or blistering diseases like varicella or dermatitis with vesicles.

Psoriasis vulgaris shows raised, well-demarcated plaques that are covered with thick, silvery scales. This hallmark comes from accelerated skin cell turnover leading to epidermal hyperplasia and parakeratosis, so the plaques are elevated and surrounded by red, inflamed skin with flaky, adherent scales. On exam, you’ll often see these plaques on extensor surfaces such as the elbows and knees, and on the scalp.

The other descriptions don’t fit because they describe conditions with little or no scale, flat non-scaly patches, or vesicles, which are more characteristic of pityriasis alba or tinea versicolor (small patches with minimal scaling), vitiligo or certain hypopigmented conditions (flat patches with no scaling), or blistering diseases like varicella or dermatitis with vesicles.