Objective To analyze the dermoscopic features at different lesions and in different disease severities among patients with psoriasis vulgaris. Methods A total of 120 patients with psoriasis vulgaris admitted to the Department of Dermatology of our hospital from January 2024 to December 2025 were selected as the subjects of investigation. Dermoscopy was performed on skin lesions to observe and record background color, scale morphology, vascular morphology and distribution. Differences in lesion features among different lesions and disease stages were compared. Results The lesion background of 120 patients with psoriasis vulgaris was mainly bright red and homogeneous, accounting for 79.17%. Scales were predominantly white (90.83%) and diffuse in distribution (60.00%). Among the vascular morphologies, dotted vessels were detected at a high rate (97.50%) and were mostly uniformly distributed (89.17%). There were statistically significant differences in lesion background, scale color, diffuse-marginal annular scale distribution, vascular morphology and vascular distribution among patients with different disease stages (P <0.05). There was no statistically significant difference between the disease stages regarding the distribution of patchy scales alone (P >0.05). There were statistically significant differences in bright?red lesions, dark?red lesions, homogeneous lesion background, glomerular vessels, hairpin vessels, linear vessels and vascular distribution among patients with different lesion sites (P <0.05). There were no statistically significant differences in scale color, scale distribution characteristics and dotted vessel morphology across different lesion sites (P >0.05). Conclusion The main dermoscopicfeatures of psoriasis vulgaris lesions include bright red background, diffuse white scales and homogeneous dotted vessels. These features can distinguish different disease stages, and site-specific vascular differences can also be identified.