Do you need a biopsy to tell if you have psoriasis?

I went to a dermatologist who said I had inverse psoriasis and a yeast infection. He biopsied my elbow that had atopic dermatitis. It became infected with cellulitis and put me in the hospital.

Dermatologist requesting biopsy

I already have multiple autoimmune diseases that make my immune system weak. I went to a second dermatologist and I didn't have any active areas. The second dermatologist said that he couldn't diagnose anything, not even my long-standing atopic dermatitis without biopsies of everything! Obviously I don't want to have infections all over from multiple biopsies and no other dermatologists have insisted on biopsies especially in sensitive areas! Is he right? Or should I find a new dermatologist? I'm not going to the first one because I moved away.

Rheumatologist focused on PsA

The rheumatologist feels like I shouldn't worry about it, but it's caused me to be unable to walk for months because of knee pain and swelling. I always have high levels of inflammatory markers so blood tests won't be helpful. The Rheumatologist says we accept the first diagnosis and start treating the initial autoimmune disease because it can be fatal and causes a lot of serious complications. If I do that, I feel like I will never have the answer if it is psoriatic arthritis causing me so much additional pain.

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