Psoriasis and the Woes of a Misdiagnosis

I've talked to many newly diagnosed psoriasis patients who have experienced the frustration of initially not knowing what was plaguing their skin. Although I was diagnosed at a very early age with having psoriasis, I too, have had my encounters of being diagnosed with something else.

A few years ago I made a visit to a new dermatologist who surveyed my skin and advised that I may have a disease called Lichen planus. She advised that my psoriasis didn't look like "Red, flaky, inflamed, patches," commonly found as the textbook definition of psoriasis (psoriasis and skin of color is a challenge within itself which will be addressed in a different blog). The doctor said that my  plaques looked more purple to dark brown and in her opinion didn't really resemble the common 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 definitely flooded my mind.

Next, the doctor took a biopsy of my skin, something I had never had in 18 years of having psoriasis. 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 I gave my skin and a week later it was determined that I, in fact, had psoriasis. Up until that moment, I've never been SO happy to actually have psoriasis. During childhood, it was also told to me that I may have been battling a skin fungus. I took loads of antibiotic meds that only caused yeast infections. Growing up sometimes it felt as though doctors really didn't know what was going on with my skin, and were just guessing.

Here are some reasons why a misdiagnosis occurs with psoriasis:

It resembles another disease

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 good as a first stop, but it shouldn't end there. A primary care physician may not know the mechanics of all skin diseases like that of a specialist such as a dermatologist, therefore a misdiagnosis is more likely. If you visit your primary care health provider first, no matter what they diagnose you with, 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, people with deep tones of skin color who have psoriasis, skin plaques will not be red. Because people of color's disease appearance not fitting the textbook definition of psoriasis, many are misdiagnosed as having other diseases, just like 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 really dry 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.

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