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Psoriasis isn’t one condition, which can lead to uncertainty, with experience required to define the problem.
A large psoriasis study in the UK has revealed that for a proportion of patients, correct diagnosis may be missed, or delayed for years. A concerning conclusion, when the research appears reliable.
The research team included members of the Global Psoriasis Atlas, the International Federation of Psoriasis Associations, the International League of Dermatological Societies and the International Psoriasis Council.
They analysed records from 700 general practices, extracting 28,762 cases of adult psoriasis, along with details of 165,160 patients without psoriasis from the same practices, to act as a control.
The Main Findings
Patients with psoriasis were up to eight times more likely than those without the condition to have been diagnosed with pityriasis rosea, a relatively minor, temporary rash of raised, red scaly patches. This tended to happen about 6 months before a correct diagnosis.
They were twice as likely to be diagnosed with eczema, or a fungal infection called tinea corporis, often around a year before a psoriasis diagnosis.
Affected patients were also more likely to have reported potential symptoms of psoriasis to their doctor, such as dry skin, a rash, skin texture changes and itching. This could be as much as 5 years before an accurate diagnosis.
Patients in the psoriasis group had been prescribed topical corticosteroids, or topical antifungals at twice the rate of those without psoriasis. In general, this occured a year or so before a correct diagnosis.
An Unwanted Outcome
The latter treatments mentioned can mask the symptoms of psoriasis, so could bring a further hold up in accurate diagnosis. Part of a range of delays, which risk the disease becoming more entrenched.
Early diagnosis can improve the effectiveness of treatment for psoriasis. A condition which affects 3% of people in the UK, can have a notable effect on their lives and is linked with other issues, such as arthritis, or heart disease.
Diagnostic errors will inevitably delay the start of appropriate treatment and increase the risk of long term impairment.
Bringing Improvement
If the study reflects general practice on a wider basis, missed opportunities for prompt diagnosis of psoriasis are relatively common. Nobody is suggesting mistakes are made due to laxity, just knowledge and awareness levels.
The researchers concluded that additional dermatology training for primary care professionals is needed, to improve their diagnostic skills.
This can lead them to suspect psoriasis in appropriate cases, investigate more thoroughly themselves, or refer patients to an experienced dermatologist. The dermatologist’s trained eye, perhaps further tests can bring an accurate conclusion.
Should you have any concerns on psoriasis diagnosis, or treatment, our team are here to help. We also hope that knowledge is improved across medical care, for a condition that can be life changing but is treatable.