The primary lesion is a red, scaling, defined papule with varying amounts of silvery scale.

Intertriginous plaques, here in the gluteal cleft, are often thin with minimal moist surface scale.

Thick inflamed plaques on the lower back with thin scale and excoriation. Occipital scalp plaques often have thick scale and well-defined borders.

Lesions may first appear on the knees, elbows, and scalp. In contrast to eczema, thick psoriatic plaques have a sharply defined border. Thick scale with thin underlying inflammation respond to topical keratolytic followed by topical steroid.