A new study by the University of Manchester finds that a psoriasis diagnosis in primary care could take up to five years.
Psoriasis is a skin condition that causes flaky patches of skin which form scales. The symptoms include patches of pink and red skin with white or silvery scales, which can cause itching and soreness. Once a patient has a psoriasis diagnosis, they can begin topical, phototherapy or systemic treatment.
The researchers published their findings in The British Journal of General Practice showing that missed opportunities with early psoriasis diagnosis are relatively common in general practice.
Quality of life and late psoriasis diagnosis
The research team reported how doctors and healthcare professionals are aware of the impact of delays in psoriasis diagnosis and treatment and how they are associated with deterioration in patients’ quality of life.
Patients diagnosed with psoriasis at a later date are twice as likely to be prescribed a steroid or antifungal creams than people without psoriasis, which may add further delay to a psoriasis diagnosis.
“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.
“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.”
Studying over 17,000 cases of psoriasis
The researchers carried out an extensive analysis of electronic health records from over 700 general practices between 2010 and 2017 across the UK, comparing clinical psoriasis diagnoses and treatments between people with and without psoriasis. They used 17,320 psoriasis cases, and 99,320 controls were used from the Clinical Practice Research Datalink Gold database.
They repeated the analyses with 11,442 cases and 65,840 controls extracted from a second database called Clinical Practice Research Datalink Aurum – with similar results.
The researchers revealed that patients with a psoriasis diagnosis were up to eight times more likely than those without psoriasis to be diagnosed with pityriasis rosea, a minor skin condition, six months before the psoriasis diagnosis. Furthermore, the patients were twice as likely to be diagnosed with eczema or tinea corporis, a fungal skin infection – one year before the psoriasis diagnosis. Additionally, these patients were more likely to report common psoriasis symptoms such as dry skin and itching before diagnosis.
GPA Director Chris Griffiths is an Emeritus Professor of Dermatology at The University of Manchester, Head of the Dermatology Theme at the NIHR Manchester Biomedical Research Centre and Honorary Consultant Dermatologist at Salford Royal NHS Foundation Trust.
He added: “Psoriasis is a long-term disease affecting around 3% of people in the UK, which substantially affects their quality of life and is linked with other serious medical conditions such as arthritis, heart disease and depression.
“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.”
