The researchers analyzed the electronic health records of more than 700 general practices in the U.K. between 2010 and 2017, comparing clinical diagnoses and treatments between people with and without psoriasis.
A total of 17,320 psoriasis cases and 99,320 controls were used from the Clinical Practice Research Datalink Gold database. They also analyzed 11,442 cases and 65,840 controls from a second database, Clinical Practice Research Datalink Aurum.
They found that patients with psoriasis were up to eight times more likely to be diagnosed with pityriasis rosea six months before a final diagnosis of psoriasis than those patients without psoriasis. At one year before the diagnosis of psoriasis, these patients were twice as likely to be diagnosed with eczema or tinea corporis. These misdiagnoses led to prescriptions for topical steroids and topical antifungal creams, leading to further masking of the underlying condition, they report.
“We already know that early diagnosis of psoriasis can improve the effectiveness of treatment for psoriasis, so these findings are pertinent,” said lead author Maha Abo-Tabik, a PhD research student at The University of Manchester in a press release.
“The World Health Organization, for example, has highlighted how many people suffer needlessly from psoriasis due to missed or delayed diagnosis. That is why we think it is essential to design additional dermatology training for primary care professionals to improve their diagnostic skills for psoriasis.”
According to Dr. Christopher E.M. Griffiths, director of the Global Psoriasis Atlas (GPA), “Psoriasis is a long-term disease affecting around three per cent of people in the U.K., which substantially affects their quality of life and is linked with other serious medical conditions such as arthritis, heart disease and depression.” He is an Emeritus Professor of Dermatology at The University of Manchester.
“The findings from this study suggest the diagnosis of psoriasis may be missed or delayed by up to five years for some individuals hence leading to a potentially detrimental delay in establishing an appropriate treatment regimen.
“It is crucial that diagnosis and treatment start as soon as possible, if patients are to reduce the risk of life-long impairment,” said Dr. Griffiths.
The research team included members of the GPA, a collaboration between the International Federation of Psoriasis Associations (IFPA), the International League of Dermatological Societies (ILDS), and the International Psoriasis Council (IPC).