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Potential signs and symptoms include: Skin Raised, reddish patches covered with thick, silvery-white, shiny scales, which may be itchy Pinpoint bleeding spots appear when scales are scraped off (Auspitz sign) Systemic Fever, dehydration, and elevated white blood cell count may occur in severe cases Other Joint stiffness or pain, including inflammation or damage in psoriatic arthritis Diagnosis The diagnosis of psoriasis is based on a physical examination of the skin, scalp, and nails