Psoriasis and the Woes of a Misdiagnosis

In my time throughout psoriasis advocacy, I've met many individuals who experienced the frustration of misdiagnosis. Although I was diagnosed with psoriasis at an early age, I have had my share of encounters with diagnosis struggles.

My own misdiagnosis journey

A few years ago, I visited a new dermatologist. They surveyed my skin and advised that I may have a disease called lichen planus. The doctor noted that my psoriasis didn't look like "red, flaky, inflamed patches" - which, in theory, is the textbook definition of the psoriasis condition.

Outside the normal description

The disparity between psoriasis and skin color is a challenge within itself. At the time, the doctor said that my plaques looked more purple to dark brown and, in her opinion, didn't resemble the standard description of psoriasis.

My initial thoughts were: You have to be kidding me. All these years of thinking I had psoriasis, and now you are telling me it could be something else I can hardly spell or pronounce?

I kid, but the thoughts and worries flooded my mind.

A skin biopsy tell all

The first time I was diagnosed at 7 years old, it was solely from the appearance of the disease. The doctor advised I was too young to have the procedure of a biopsy, so it never happened. Now, 18 years later - it was what this new doctor wanted to do.

So I gave my skin, and a week later, it was determined that I had psoriasis. Until that moment, I've never been so happy to have a diagnosis of psoriasis.

Growing up, sometimes it felt as though doctors didn't know what was going on with my skin and were guessing.

Why is a diagnosis of psoriasis so difficult?

A lot of skin diseases look alike. The differences are thecause of the skin issue. Also, a lot of people tend to visit a primary care physician before seeing a dermatologist, which may even be required by some insurance companies.

Seeing a general practice physician may be suitable as a first step, but it shouldn't end there. A primary care physician may not know the mechanics of all skin diseases like that a specialist such as a dermatologist therefore, a misdiagnosis is more likely.

Suppose you visit your primary care health provider first. No matter what, they diagnose you. In that case, you should see a dermatologist for a second opinion.

Its appearance is not "red, itchy, patches" of dry skin

I can't stress this point enough, for people with deep tones of skin color who have psoriasis, skin plaques will not be red.

Because people of color's disease appearance does not fit the textbook definition of psoriasis, many are misdiagnosed as having other diseases, just as I expressed in my story earlier.

It's self-diagnosed as dry skin

My psoriasis patches appeared way before I was diagnosed. We thought it was just dehydrated skin because my disease was only on my knees and elbows, which tend to appear as dryer, thicker areas on everyone in general.

I spoke to a fellow psoriasis sufferer who advised that before he was diagnosed with psoriasis, his mother assumed he wasn't putting on enough lotion, hence the flakiness of his skin. It wasn't until years later the doctor told him he had psoriasis and not just dry skin.

It appears in an embarrassing place

Some people have genital psoriasis, also referred to as inverse psoriasis, but are too afraid and embarrassed to inform their doctor.

Therefore the disease goes undiagnosed or misdiagnosed until it appears in a more common place.

It's often felt but not yet seen

Although studies show 30% of people with psoriasis will develop psoriatic arthritis, it is unclear how many people will get arthritis symptoms before their psoriasis symptoms appear.

I encountered a lady at my old job who advised she had suffered from joint pain for years from arthritis, but the psoriasis component didn't appear until several years later.