How is psoriasis diagnosed? Psoriasis is typically diagnosed clinically on exam. Very rarely is a biopsy helpful. However, it can be used when narrowing down a diagnosis in a patient who may otherwise have been misdiagnosed in the past, is not responding to treatment or is getting progressively worse despite intervention. Seeing a positive response to treatment for psoriasis is often a confirmation of the diagnosis itself. Usually no additional investigations or tests are required, since it's primarily a clinical diagnosis. Your doctor or dermatologist will sometimes ask questions about your health and examine your skin, scalp and nails. Your doctor might take a small sample or biopsy for examination under a microscope for histology. This helps determine the type of psoriasis and rule out other disorders that could possibly confound it. Typical histologic findings of psoriasis include acanthosis or thickening of the skin with elongated [?], hypogranulosis or a decreased granular layer, hyper and parakeratosis of the epidermis, dilated blood vessels in the epidermis, and a perivascular infiltrate of lymphocytes with neutrophils singly, or with an aggregates in the epidermis, the top layer of the skin.
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